MEDICARE: NORTHERN MANHATTEN WOMENS HEALTH, AN OB/GYN P.C.

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	207V00000X	Obstetrics & Gynecology Physician	215831	NY

General Provider Information

NPI Number	:	1619026473
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHERN MANHATTEN WOMENS HEALTH, AN OB/GYN P.C.

Provider Business Mailing Address
First Line	:	400 FORT WASHINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-6849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 FORT WASHINGTON AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10033-6849
Country	:	US
Telephone Number	:	212-923-8550
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EBRAHIM S SHAHIM
Credential	:	M.D.
Telephone Number	:	212-923-8550

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	10/12/2007

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