Healthcare Provider Details

I. General information

NPI: 1750106589
Provider Name (Legal Business Name): SHABEE ZAHRA BUKHARI RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2024
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE ST
PHILADELPHIA PA
19104-4238
US

IV. Provider business mailing address

605 JAMIE CIR
KING OF PRUSSIA PA
19406-1975
US

V. Phone/Fax

Practice location:
  • Phone: 610-308-9581
  • Fax:
Mailing address:
  • Phone: 610-308-9581
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN008706
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: