Provider Demographics
NPI:1922307578
Name:DAHAN, SHAYNA ARIELLA (CPNP)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:ARIELLA
Last Name:DAHAN
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 HAVEN AVE
Mailing Address - Street 2:GROUND FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1131
Mailing Address - Country:US
Mailing Address - Phone:212-923-5500
Mailing Address - Fax:212-740-2069
Practice Address - Street 1:135 HAVEN AVE
Practice Address - Street 2:GROUND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1131
Practice Address - Country:US
Practice Address - Phone:212-923-5500
Practice Address - Fax:212-740-2069
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF382190-1208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics