Shirley Blum, LPN

Individual provider Active NPI Licensed Practical Nurse · Monticello, NY

NPI 1922465038 · NPPES record last updated Jan 20, 2016

Key facts

NPI
1922465038
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
324367 (NY)
Practice address
17 Hamilton Ave
Monticello, NY 12701-1319
Phone
(845) 794-8080
Fax
(845) 791-1716
NPI assigned
Jan 20, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
324367NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 324367 NY Yes

Addresses

Primary practice location

17 Hamilton Ave
Monticello, NY 12701-1319

Mailing address

17 Hamilton Ave
Monticello, NY 12701-1319
Phone (845) 794-8080

Other names

  • Shirley Lewis Former name

Other providers in Monticello, NY

All providers in Monticello, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.