MEDICARE: SHABBIR A ABBASI M.D.

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	2084N0400X	Neurology Physician	20451	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0021255	OTHER	MA	NHP
2	J22690	OTHER	MA	BCBSMA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	204510	OTHER	MA	THP
5	0858936001	OTHER	MA	CIGNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	51111	OTHER	MA	FCHP
8	7699236	OTHER	MA	AETNA
9	01Y003569MA01	OTHER	NH	ANTHEM
10	111099	OTHER	MA	HPHC

General Provider Information

NPI Number	:	1992798797
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHABBIR A ABBASI M.D.

Provider Business Mailing Address
First Line	:	PO BOX 415348
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-5348
Country	:	US
Telephone Number	:	800-225-8885
Fax Number	:	508-334-8105

Provider Business Practice Location Address
First Line	:	50 MEMORIAL DR
Second Line	:
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-2238
Country	:	US
Telephone Number	:	978-466-2411
Fax Number	:	978-466-2418

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

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	12/15/2020

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