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General NPI Number Information
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NPI Number | 1700258308
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Entity Type | Individual
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Provider Name | MOHSIN AHMED MUKHTAR SHAIKH PH.D. CCC-A
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Gender | Male
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Dates
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Enumeration Date | 10/22/2015
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Last Update Date | 05/04/2018
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Provider Practice Location Address
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Address Line | 400 E. 2ND ST CENTENNIAL HALL
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City | BLOOMSBURG
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State | PA
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Zip | 17815-1301
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Country | US
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Telephone | 570-389-5380
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Fax | 570-389-5022
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Provider Business Mailing Address
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Address Line | PO BOX 1388
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City | KINGSTON
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State | PA
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Zip | 18704-0388
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Country | US
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Telephone | 570-288-8881
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Fax | 570-288-8065
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD157
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AT006491
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License Number State | PA
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