The Shield of David, Inc.
NPI 1184661290ActiveOrganization· Clinic/Center· Bayside, NY
Clinic/Center in Bayside, New York, registered in NPPES in May 2006. The authorized official on file is Susan Provenzano, Executive Director. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184661290 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 31, 2006 |
| Last updated in NPPES | Apr 24, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Clinic/Center Primary | 261Q00000X | 6593164 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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