Healthcare Provider Details

I. General information

NPI: 1629622477
Provider Name (Legal Business Name): DR TAYEBA SHAIKH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

623 EAGLE ROCK AVE
WEST ORANGE NJ
07052-2948
US

IV. Provider business mailing address

206 BLOOMFIELD AVE APT 301
BLOOMFIELD NJ
07003-5761
US

V. Phone/Fax

Practice location:
  • Phone: 513-259-4711
  • Fax: 201-228-9980
Mailing address:
  • Phone: 513-259-4711
  • Fax: 201-228-9980

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: TAYEBA SHAIKH ALHOCH
Title or Position: OWNER
Credential: PSY D
Phone: 513-259-4711