Provider Demographics
NPI:1790922136
Name:SHAYEB, AMR (MD)
Entity Type:Individual
Prefix:
First Name:AMR
Middle Name:
Last Name:SHAYEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6852 FRESH POND RD LL
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-5230
Mailing Address - Country:US
Mailing Address - Phone:718-497-3045
Mailing Address - Fax:718-497-3126
Practice Address - Street 1:6852 FRESH POND RD
Practice Address - Street 2:LOWER LEVEL
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-5230
Practice Address - Country:US
Practice Address - Phone:718-497-3045
Practice Address - Fax:718-497-3126
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2021-04-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY003649207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY390200000XMedicare UPIN