Provider Demographics
NPI:1265001754
Name:SHAABAN, SAMEH
Entity Type:Individual
Prefix:
First Name:SAMEH
Middle Name:
Last Name:SHAABAN
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 1:2407 LORING PL
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-3720
Mailing Address - Country:US
Mailing Address - Phone:646-824-8008
Mailing Address - Fax:
Practice Address - Street 1:2407 LORING PL
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-3720
Practice Address - Country:US
Practice Address - Phone:646-824-8008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth