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General NPI Number Information
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NPI Number | 1023052982
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Entity Type | Individual
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Provider Name | SHABNAM SHAKIBAIE SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 12/20/2013
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Provider Practice Location Address
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Address Line | 160 W END AVE STE IN
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City | NEW YORK
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State | NY
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Zip | 10023-5601
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Country | US
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Telephone | 646-620-9158
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Fax | 877-919-4362
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Provider Business Mailing Address
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Address Line | 160 WEST END AVENUE SUITE 1N
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City | NEW YORK
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State | NY
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Zip | 10023
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Country | US
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Telephone | 212-305-2330
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Fax | 212-305-4724
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 239512
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License Number State | NY
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