Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 168148 | NY |
NPI | 1043389620 |
---|---|
Provider Name | Dr. Mohamad Shafi |
First Address | Cheektowaga, NY 14225-2001 |
Second Address | Cheektowaga, NY 14225-2001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 03/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00010162401 | UNIVERA (01) | NY |
000510466001 | BLUE CROSS (01) | NY |
000510466001 | CBLUE (01) | NY |
011195398 | (05) | NY |
041216000052 | FIDELIS (01) | NY |
2502708 | INDEPENDENT HEALTH (01) | NY |
390000809 | MEDICARE TRAVELERS (01) | NY |
A79761 | (02) | NY |