Provider Demographics
NPI:1124181672
Name:SHAABAN, MAGDY MAHMOUD (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:MAHMOUD
Last Name:SHAABAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 SUNRISE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570
Mailing Address - Country:US
Mailing Address - Phone:516-223-0700
Mailing Address - Fax:516-223-5347
Practice Address - Street 1:180 SUNRISE HIGHWAY
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570
Practice Address - Country:US
Practice Address - Phone:516-223-0700
Practice Address - Fax:516-223-5347
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183174207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01836511Medicaid
NYF23909Medicare UPIN
NY53K021Medicare ID - Type Unspecified