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General NPI Number Information
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NPI Number | 1316270333
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Entity Type | Organization
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Legal Business Name | SHAHEM MD, PC.
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 06/25/2015
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Provider Practice Location Address
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Address Line | 654 84TH ST
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City | BROOKLYN
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State | NY
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Zip | 11228-2820
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Country | US
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Telephone | 718-921-1661
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Fax | 813-337-0360
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Provider Business Mailing Address
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Address Line | 654 84TH ST
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City | BROOKLYN
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State | NY
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Zip | 11228-2820
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Country | US
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Telephone | 718-921-1661
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Fax | 813-337-0360
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAHER SHAHEM
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Credential | M.D.
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Telephone | 718-921-1661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 224199
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License Number State | NY
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