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General NPI Number Information
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NPI Number | 1558522383
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Entity Type | Individual
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Provider Name | ARIF SHAHABUDDIN MD
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Gender | Male
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 47 NEW SCOTLAND AVE DEPARTMENT OF PSYCHIATRY
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City | ALBANY
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State | NY
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Zip | 12208-3412
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Country | US
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Telephone | 518-626-5511
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Fax |
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Provider Business Mailing Address
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Address Line | 461 STATE ST FIRST FLOOR
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City | ALBANY
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State | NY
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Zip | 12203-1022
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Country | US
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Telephone | 617-460-1475
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 62537
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License Number State | NY
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