Provider Demographics
NPI:1467141051
Name:NIROOMAND, SHABNAM
Entity Type:Individual
Prefix:
First Name:SHABNAM
Middle Name:
Last Name:NIROOMAND
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 1:2800 MEREDITH CT
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1849
Mailing Address - Country:US
Mailing Address - Phone:443-668-9420
Mailing Address - Fax:
Practice Address - Street 1:2800 MEREDITH CT
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:MD
Practice Address - Zip Code:21009-1849
Practice Address - Country:US
Practice Address - Phone:443-668-9420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach