Provider Demographics
NPI:1225396161
Name:SHAHEEN, CRISTINA (PSYD)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:
Last Name:SHAHEEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 AMBOY AVE
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2471
Mailing Address - Country:US
Mailing Address - Phone:732-784-3536
Mailing Address - Fax:732-784-3632
Practice Address - Street 1:296 AMBOY AVE
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2471
Practice Address - Country:US
Practice Address - Phone:732-784-3536
Practice Address - Fax:732-784-3532
Is Sole Proprietor?:No
Enumeration Date:2012-04-29
Last Update Date:2023-05-09
Deactivation Date:2021-01-05
Deactivation Code:
Reactivation Date:2021-04-07
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00541600103T00000X
NJ5416103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist