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General NPI Number Information
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NPI Number | 1982443073
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Entity Type | Individual
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Provider Name | MOHAMMED HASAN SHAHID
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Gender | Male
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Dates
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Enumeration Date | 05/20/2024
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 6 MEDICAL PLZ
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City | GLEN COVE
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State | NY
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Zip | 11542-2108
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Country | US
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Telephone | 516-656-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 1239 BAY RIDGE PKWY FL 2
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City | BROOKLYN
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State | NY
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Zip | 11228-2401
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Country | US
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Telephone | 917-676-8883
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | P125348
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License Number State | NY
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