Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Shalom Jaroslawicz

Individual provider Family Nurse Practitioner · NPI 1407445257

Shalom Jaroslawicz is a Nurse Practitioner in Valley Stream, New York. Qualified in 2020, 6 years ago. Practices with Prime MD Center LLC, a 4-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2021
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Practice location Address checks out

701 Mulberry Pl
Valley Stream, NY 11581-3131
Phone: (646) 842-2367
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 347138 (NY)

Record details

NPI number1407445257
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedJanuary 15, 2021
Last updated in NPPESJanuary 15, 2021
Certification dateJanuary 15, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Prime Md Center Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Valley Stream