Healthcare Provider Details

I. General information

NPI: 1184543597
Provider Name (Legal Business Name): SHATHA ALBASHIR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2026
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 ALEXANDER ST APT 3405
YONKERS NY
10701-5395
US

IV. Provider business mailing address

80 ALEXANDER ST APT 3405
YONKERS NY
10701-5395
US

V. Phone/Fax

Practice location:
  • Phone: 929-420-4114
  • Fax:
Mailing address:
  • Phone: 929-420-4114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number050217-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: