Provider Demographics
NPI:1891841987
Name:PARTI, SHABNUM K (OD)
Entity Type:Individual
Prefix:MS
First Name:SHABNUM
Middle Name:K
Last Name:PARTI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 FREMONT ST
Mailing Address - Street 2:UNIT 406
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2371
Mailing Address - Country:US
Mailing Address - Phone:404-822-3127
Mailing Address - Fax:
Practice Address - Street 1:160 FREMONT ST
Practice Address - Street 2:UNIT 406
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2371
Practice Address - Country:US
Practice Address - Phone:404-822-3127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA01482152W00000X
MA4784152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist