Provider Demographics
NPI:1508530023
Name:SHAHANI, JAVERIA
Entity Type:Individual
Prefix:
First Name:JAVERIA
Middle Name:
Last Name:SHAHANI
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 1:1030 BOXELDER LN # 1030
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1624
Mailing Address - Country:US
Mailing Address - Phone:980-465-9073
Mailing Address - Fax:
Practice Address - Street 1:1030 BOXELDER LN # 1030
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1624
Practice Address - Country:US
Practice Address - Phone:980-465-9073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-07
Last Update Date:2021-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program