MEDICARE: DIYORA SHEHU PA

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	363A00000X	Physician Assistant
2	363A00000X	Physician Assistant	026456	NY

General Provider Information

NPI Number	:	1407458466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIYORA SHEHU PA

Provider Business Mailing Address
First Line	:	1 EMBARCADERO CTR STE 1900
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-3723
Country	:	US
Telephone Number	:	415-658-6791
Fax Number	:	415-520-0904

Provider Business Practice Location Address
First Line	:	2633 BROADWAY
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-5022
Country	:	US
Telephone Number	:	212-321-7001
Fax Number	:	415-252-7176

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

Provider Enumeration Date	:	11/13/2020
Last Update Date	:	04/09/2026

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Directions to “ DIYORA SHEHU PA” Practice Location

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