Individual ProviderShanequa MarshallLicensed Practical NurseNursing Service ProvidersPractice Address100 Park Ave Apt 1, Amityville, NY 11701-3165(516) 614-2529PECOS EnrollmentBased on the most recent information from CMS, provider Shanequa Marshall does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:43 AM.Profile DetailsProvider ID1538760608Provider TypeIndividualFull NameMarshall, ShanequaCredentialLPNGenderFemaleSole ProprietorYesEnumeration Date11/5/2020Last Updated11/5/2020Contact InformationPractice LocationPractice Address100 Park Ave Apt 1, Amityville, NY 11701-3165Phone(516) 614-2529FaxUnlisted FaxMailing LocationMailing Address100 Park Ave Apt 1, Amityville, NY 11701-3165Phone(516) 614-2529FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense340044New York