Healthcare Provider Details

I. General information

NPI: 1285229757
Provider Name (Legal Business Name): SHAINA SHAGALOW PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 E 98TH ST FL 7
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

518 E 82ND ST APT 4R
NEW YORK NY
10028-7192
US

V. Phone/Fax

Practice location:
  • Phone: 347-941-3222
  • Fax:
Mailing address:
  • Phone: 347-941-3222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number027556
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: