Provider Demographics
NPI:1447016738
Name:SABOONE NP IN PSYCHIATRY, PLLC
Entity type:Organization
Organization Name:SABOONE NP IN PSYCHIATRY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:SHANEQUA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOONE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:631-629-2269
Mailing Address - Street 1:250 FULTON AVE STE 340
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-3917
Mailing Address - Country:US
Mailing Address - Phone:631-629-2269
Mailing Address - Fax:
Practice Address - Street 1:250 FULTON AVE STE 340
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-3917
Practice Address - Country:US
Practice Address - Phone:631-629-2269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty