Provider Demographics
NPI:1043552037
Name:SHABAZZ, SAHAR A (MASTERS)
Entity Type:Individual
Prefix:MS
First Name:SAHAR
Middle Name:A
Last Name:SHABAZZ
Suffix:
Gender:F
Credentials:MASTERS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SAINT NICHOLAS AVE
Mailing Address - Street 2:APT # 8N
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-7620
Mailing Address - Country:US
Mailing Address - Phone:646-755-8654
Mailing Address - Fax:
Practice Address - Street 1:400 SAINT NICHOLAS AVE
Practice Address - Street 2:APT # 8N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-7620
Practice Address - Country:US
Practice Address - Phone:646-755-8654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist