Provider Demographics
NPI:1346559002
Name:MUHLBAUER, SHAYNA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SHAYNA
Middle Name:
Last Name:MUHLBAUER
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 1:10914 ASCAN AVE
Mailing Address - Street 2:6F
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5370
Mailing Address - Country:US
Mailing Address - Phone:917-254-3420
Mailing Address - Fax:
Practice Address - Street 1:3 W 95TH ST
Practice Address - Street 2:3 FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6753
Practice Address - Country:US
Practice Address - Phone:917-254-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021017103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist