Provider Demographics
NPI:1194369298
Name:SHANAWANI, HUDA H
Entity Type:Individual
Prefix:
First Name:HUDA
Middle Name:H
Last Name:SHANAWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 CANOE BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1117
Mailing Address - Country:US
Mailing Address - Phone:973-943-9649
Mailing Address - Fax:
Practice Address - Street 1:15 CANOE BROOK RD
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-1117
Practice Address - Country:US
Practice Address - Phone:973-943-9649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty