Provider Demographics
NPI:1619268745
Name:SHAHID, WASEEM (MD)
Entity Type:Individual
Prefix:DR
First Name:WASEEM
Middle Name:
Last Name:SHAHID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 CENTRAL PARK AVE
Mailing Address - Street 2:APT D
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1361
Mailing Address - Country:US
Mailing Address - Phone:347-223-6987
Mailing Address - Fax:
Practice Address - Street 1:161 BOSTON AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06610-1662
Practice Address - Country:US
Practice Address - Phone:203-333-4400
Practice Address - Fax:203-334-0729
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT53804207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine