SHANELLE TASHAE GRAHAM (NPI# 1972027092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972027092 |
| Entity Type | Individual |
| Full Name | SHANELLE TASHAE GRAHAM |
| Credential | PA-C |
| Practice Address |
1 Healthy Way Oceanside NY 11572-1551 |
| Mailing Address |
98 Perry St Hempstead NY 11550-5220 |
| Practice Telephone | 5166323000 |
| Mailing Telephone | 3472820528 |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2017-07-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
20801 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1 HEALTHY WAY |
| City | OCEANSIDE |
| State | NY |
| Zip Code | 11572-1551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824606 | Edward E Mullen | Specialist | 1 Healthy Way, Oceanside, NY 11572-1551 | 2005-07-08 |
| 1831796812 | Diane S Mcdevitt | Nurse Practitioner | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-10-03 |
| 1053921742 | Mount Sinai School of Medicine | Psychiatry & Neurology | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-08-06 |
| 1841809886 | Rizvi Surgical Care Pllc | Surgery | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-07-27 |
| 1760004022 | Vascular Care LLC | Surgery | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-05-09 |
| 1023639937 | Florence Dasrath | Student in an Organized Health Care Education/Training Program | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-05-01 |
| 1730709312 | Jordana Schmidt-swartz | Student in an Organized Health Care Education/Training Program | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-04-23 |
| 1336769207 | Nia Jagroop | Student in an Organized Health Care Education/Training Program | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-04-21 |
| 1366062523 | Gladys Isabel Palaguachi | Student in an Organized Health Care Education/Training Program | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-04-17 |
| 1578182846 | Amit Elazar | Student in an Organized Health Care Education/Training Program | 1 Healthy Way, Oceanside, NY 11572-1551 | 2020-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152868 | True North Dialysis Center LLC | Clinic/Center | 3005 Long Beach Rd, Oceanside, NY 11572 | 2020-07-30 |
| 1508493560 | Mercedes Andreina Cardenas Pena | Student in an Organized Health Care Education/Training Program | 196 South Nassau, Oceanside, NY 11572 | 2020-03-26 |
| 1275170219 | Prohealth Dental Pllc | Dentist | 2870 Long Beach Road, Oceanside, NY 11572 | 2019-12-10 |
| 1982252409 | Fe Jaurigue | Nurse Practitioner | 2391 Washington Ave, Oceanside, NY 11572 | 2019-08-28 |
| 1689160749 | Emil A Tocci, Dc, PC | Chiropractor | 3091 Lawson Blvd, Oceanside, NY 11572 | 2018-07-02 |
| 1336652726 | Jennifer L Rodgers | Nurse Practitioner | 435 Kinsley Ct, Oceanside, NY 11572 | 2017-11-08 |
| 1205387859 | Joanne Hudkins | Nurse Practitioner | 3353 5th St, Oceanside, NY 11572 | 2016-10-19 |
| 1346693595 | Michelle Coletta-guadagno | Case Manager/Care Coordinator | 400 Oceanside Pkwy, Oceanside, NY 11572 | 2016-07-22 |
| 1831543271 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 3705 Hampton Rd, Oceanside, NY 11572 | 2016-04-22 |
| 1598170474 | Amy Daleo | Licensed Practical Nurse | 299 Waukena Ave, Oceanside, NY 11572 | 2014-06-30 |
| Find all providers in zip 11572 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273617 | Chelsea Marie Ellingson | Physician Assistant | 3142 Vista Way Ste 401, Oceanside, CA 92056-3619 | 2019-09-07 |
| 1164846747 | Stephen F Funk | Physician Assistant | 3037 David Ct, Oceanside, NY 11572-4415 | 2014-02-18 |
| 1205026861 | Kelly T. Sales | Physician Assistant | 3230 Waring Ct Ste J, Oceanside, CA 92056-4509 | 2007-07-30 |
| 1346306123 | Susan Radoff | Physician Assistant | 3910 Vista Way Ste 106, Oceanside, CA 92056-4513 | 2006-12-28 |
| 1326076043 | Michelle F. Buxton | Physician Assistant | 4318 Mission Ave, Oceanside, CA 92057-6541 | 2006-06-29 |
| 1831135409 | Don Juan Ortiz | Physician Assistant | 465 College Blvd., Ste. 1, Oceanside, CA 92057 | 2006-06-21 |
| 1518953660 | Robin M. Waggoner | Physician Assistant | 3142 Vista Way, Suite 100, Oceanside, CA 92056-3627 | 2005-09-23 |
| 1194223834 | Waqas Ali | Physician Assistant | 1 Healthy Way, Oceanside, NY 11572-1551 | 2018-01-29 |
| 1316465214 | Alyson Wentworth | Physician Assistant | 200 Mercy Circle, Oceanside, CA 92055 | 2017-08-31 |
| 1912378332 | Taera Young Felkins | Physician Assistant | 605 Crouch St, Oceanside, CA 92054-4415 | 2015-10-12 |
| Find all providers in OCEANSIDE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.