Provider Demographics
NPI:1629622477
Name:DR TAYEBA SHAIKH
Entity Type:Organization
Organization Name:DR TAYEBA SHAIKH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAYEBA
Authorized Official - Middle Name:SHAIKH
Authorized Official - Last Name:ALHOCH
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:513-259-4711
Mailing Address - Street 1:206 BLOOMFIELD AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-5761
Mailing Address - Country:US
Mailing Address - Phone:513-259-4711
Mailing Address - Fax:201-228-9980
Practice Address - Street 1:623 EAGLE ROCK AVE
Practice Address - Street 2:
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-2948
Practice Address - Country:US
Practice Address - Phone:513-259-4711
Practice Address - Fax:201-228-9980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-30
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04789924Medicaid