Provider Demographics
NPI:1770682254
Name:SHABSIN, HARRY S (PHD)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:S
Last Name:SHABSIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 N. CHARLES ST.
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-1040
Mailing Address - Country:US
Mailing Address - Phone:410-377-8454
Mailing Address - Fax:410-377-8385
Practice Address - Street 1:6301 N. CHARLES ST.
Practice Address - Street 2:SUITE 4
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-1040
Practice Address - Country:US
Practice Address - Phone:410-377-8454
Practice Address - Fax:410-377-8385
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD1763103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDGH39Medicare ID - Type Unspecified