MEDICARE: DR. PAUL SHAHINIAN OD

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
1	152W00000X	Optometrist	4165	NJ

General Provider Information

NPI Number	:	1245296755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL SHAHINIAN OD

Provider Business Mailing Address
First Line	:	104 LINWOOD PLZ
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-3701
Country	:	US
Telephone Number	:	201-461-0661
Fax Number	:	201-461-4111

Provider Business Practice Location Address
First Line	:	104 LINWOOD PLZ
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-3701
Country	:	US
Telephone Number	:	201-461-0661
Fax Number	:	201-461-4111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	09/18/2008

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