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General NPI Number Information
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NPI Number | 1992068209
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Entity Type | Individual
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Provider Name | MS. SHABANA RAPHEAN SHARIF
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Gender | Female
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 115-25 METROPOLITAN AVE APT 224
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City | RICHMOND HILL
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State | NY
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Zip | 11418-1001
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Country | US
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Telephone | 917-528-8885
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Fax |
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Provider Business Mailing Address
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Address Line | 11525 METROPOLITAN AVE APT 224
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City | RICHMOND HILL
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State | NY
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Zip | 11418-1001
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 539894112
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License Number State | NY
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