Healthcare Provider Details

I. General information

NPI: 1841753951
Provider Name (Legal Business Name): SHAHAM BEG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4422 3RD AVE FL 3
BRONX NY
10457-2545
US

IV. Provider business mailing address

4422 3RD AVE FL 3
BRONX NY
10457-2545
US

V. Phone/Fax

Practice location:
  • Phone: 718-960-6150
  • Fax: 718-960-3617
Mailing address:
  • Phone: 718-960-6150
  • Fax: 718-960-3617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number320901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: