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General NPI Number Information
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NPI Number | 1306503214
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Entity Type | Individual
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Provider Name | MR. SHAN AKHTAR HAROON
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Gender | Male
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Dates
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Enumeration Date | 11/26/2021
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Last Update Date | 11/26/2021
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Provider Practice Location Address
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Address Line | 177B E MAIN ST
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City | NEW ROCHELLE
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State | NY
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Zip | 10801-5711
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Country | US
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Telephone | 914-730-9574
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Fax |
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Provider Business Mailing Address
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Address Line | 12322 NW 54TH CT
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City | CORAL SPRINGS
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State | FL
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Zip | 33076-3410
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Country | US
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Telephone | 954-796-0364
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 009473
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License Number State | NY
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