Provider Demographics
NPI:1497840458
Name:SHAIKH, SHAHIN FIROZ (MD)
Entity Type:Individual
Prefix:
First Name:SHAHIN
Middle Name:FIROZ
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 MEDFORD AVE
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-1202
Mailing Address - Country:US
Mailing Address - Phone:631-758-5864
Mailing Address - Fax:631-654-2024
Practice Address - Street 1:90 MEDFORD AVE
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772
Practice Address - Country:US
Practice Address - Phone:631-758-5864
Practice Address - Fax:631-654-2024
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1665381207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01275910Medicaid
D92009Medicare UPIN
18F311Medicare ID - Type Unspecified