Provider Demographics
NPI:1437277795
Name:JESSANI, SHABANA JAWED (MD)
Entity Type:Individual
Prefix:DR
First Name:SHABANA
Middle Name:JAWED
Last Name:JESSANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SHABANA
Other - Middle Name:JAFFER
Other - Last Name:ALI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3000 N ARIZONA AVE
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-7717
Mailing Address - Country:US
Mailing Address - Phone:480-827-5540
Mailing Address - Fax:480-207-2111
Practice Address - Street 1:3000 N ARIZONA AVE
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7717
Practice Address - Country:US
Practice Address - Phone:480-827-5540
Practice Address - Fax:480-207-2111
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ322222080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics