Provider Demographics
NPI:1841793403
Name:HIRANI, SHABEENA S
Entity Type:Individual
Prefix:
First Name:SHABEENA
Middle Name:S
Last Name:HIRANI
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 1:8720 QUEENS BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4419
Mailing Address - Country:US
Mailing Address - Phone:718-280-9680
Mailing Address - Fax:718-899-3300
Practice Address - Street 1:8720 QUEENS BLVD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-4419
Practice Address - Country:US
Practice Address - Phone:718-280-9680
Practice Address - Fax:718-899-3300
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2018-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF342797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily