National Provider Identifier
Jasmine Shaddai Carroll
Jasmine Shaddai Carroll is listed in the NPPES registry with a primary specialty of Peer Specialist in Buffalo, NY and a listed phone number of (716) 856-2587.
Profile Overview
- NPI
- 1588286280
- Provider Type
- Individual
- Primary Specialty
- Peer Specialist
- Enumeration Date
- May 15, 2020
- Last Updated
- May 15, 2020
Practice Location
- 1050 Niagara St
- Buffalo, NY 14213-2001
Phone: (716) 856-2587
Specialties
- Peer Specialist (175T00000X)
Full Record
- NPI
- 1588286280
- Entity Type
- Individual
- Last Name
- Carroll
- First Name
- Jasmine
- Middle Name
- Shaddai
- Provider Other Last Name
- Tirado-Nordine
- Provider Other First Name
- Jasmine
- Provider Other Middle Name
- Shaddai
- Provider Other Last Name Type Code
- 1
- Mailing Street Address
- 1050 Niagara St
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14213-2001
- Mailing Country
- US
- Mailing Phone
- (716) 856-2587
- Practice Street Address
- 1050 Niagara St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14213-2001
- Practice Country
- US
- Practice Phone
- (716) 856-2587
- Enumeration Date
- May 15, 2020
- Last Updated
- May 15, 2020
- Sex
- Female
- Sole Proprietor
- No
- Certification Date
- May 15, 2020
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Peer Specialist (175T00000X)