Shady Bourham
Shady Bourham is a Licensed Practical Nurse in Brooklyn, New York. Practices as a sole proprietor. Licensed in New York.
- Licensed in
- NY
- In the registry since
- 2016
Practice location Address checks out
6321 New Utrecht AveBrooklyn, NY 11219-5425
Phone: (212) 687-7464
Fax: (212) 257-7016
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Licensed Practical Nurse (primary) | Taxonomy 164W00000X · Licence 327253 (NY) |
|---|
Record details
| NPI number | 1316480643 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | November 18, 2016 |
| Last updated in NPPES | November 18, 2016 |
| Mailing address | 250 Central Ave, Apt215-B, Newark, NJ 07103-4201 |
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