Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 274938 | NY |
Y | 208600000X | Surgeon | 274938 | NY |
NPI | 1003046285 |
---|---|
Provider Name | Dr. Shabana Perveen |
First Address | Dix Hills, NY 11746-5101 |
Second Address | Huntington, NY 11743-4240 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 30/06/2016 |