Provider Demographics
NPI:1942515242
Name:HASNAYEN, SHAHED MAHFUZ (MD)
Entity Type:Individual
Prefix:
First Name:SHAHED
Middle Name:MAHFUZ
Last Name:HASNAYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 134TH ST APT 5G
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1441
Mailing Address - Country:US
Mailing Address - Phone:347-563-6616
Mailing Address - Fax:
Practice Address - Street 1:82-35 134 ST
Practice Address - Street 2:APT 5G
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435
Practice Address - Country:US
Practice Address - Phone:718-374-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY258041207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine