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NPI Code Detail

MEDICARE: SHAWNEE Z SEBBAG MD

MEDICARE: SHAWNEE Z SEBBAG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training ProgramNJ

General Provider Information

NPI Number : 1164364360
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWNEE Z SEBBAG MD
Provider Business Mailing Address
First Line : 2422 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-1606
Country : US
Telephone Number : 646-552-4042
Fax Number :
Provider Business Practice Location Address
First Line : 425 JACK MARTIN BLVD
Second Line :
City : BRICK
State : NJ
Zip : 08724-7732
Country : US
Telephone Number : 732-840-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2026
Last Update Date : 04/07/2026

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Directions to “ SHAWNEE Z SEBBAG MD” Practice Location

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