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General NPI Number Information
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NPI Number | 1962889618
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Entity Type | Individual
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Provider Name | SHEBANI PAHWA
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Gender | Female
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Dates
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Enumeration Date | 05/01/2015
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Last Update Date | 11/19/2019
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Provider Practice Location Address
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Address Line | 111 E 57TH ST # 204
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City | NEW YORK
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State | NY
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Zip | 10022-2009
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Country | US
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Telephone | 301-910-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 721 5TH AVE APT 37F
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City | NEW YORK
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State | NY
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Zip | 10022-2537
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Country | US
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Telephone | 301-910-3100
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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 | 16163
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DEN1001562
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 060299-1
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License Number State | NY
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