Provider Demographics
NPI:1053651752
Name:HAKEEM, SHAMIR ABDULLAH
Entity Type:Individual
Prefix:
First Name:SHAMIR
Middle Name:ABDULLAH
Last Name:HAKEEM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 KEAP ST APT 2H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-6466
Mailing Address - Country:US
Mailing Address - Phone:718-415-2631
Mailing Address - Fax:
Practice Address - Street 1:706 QUINCY ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-2210
Practice Address - Country:US
Practice Address - Phone:718-443-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY693465121103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst