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General NPI Number Information
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NPI Number | 1326366642
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Entity Type | Individual
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Provider Name | SHAZIA AKHTAR D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/11/2010
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Last Update Date | 08/18/2011
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Provider Practice Location Address
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Address Line | 28-39 214TH PL
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City | BAYSIDE
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State | NY
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Zip | 11360-2625
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Country | US
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Telephone | 718-229-1916
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Fax |
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Provider Business Mailing Address
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Address Line | 28-39 214TH PL
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City | BAYSIDE
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State | NY
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Zip | 11360-2625
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Country | US
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Telephone | 718-902-2740
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 055629
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License Number State | NY
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