Healthcare Provider Details

I. General information

NPI: 1760327902
Provider Name (Legal Business Name): HABIBA SHAFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10530 86TH ST
OZONE PARK NY
11417-1307
US

IV. Provider business mailing address

10530 86TH ST
OZONE PARK NY
11417-1307
US

V. Phone/Fax

Practice location:
  • Phone: 347-251-6279
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number031113
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: