Provider Demographics
NPI:1265723613
Name:SHOAIB, HUMAIRA (MD)
Entity type:Individual
Prefix:
First Name:HUMAIRA
Middle Name:
Last Name:SHOAIB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270-05 76TH AVE.
Mailing Address - Street 2:LIJ MEDICAL CENTER STAFF HOUSE, ROOM 210B
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040
Mailing Address - Country:US
Mailing Address - Phone:718-470-4650
Mailing Address - Fax:516-354-6491
Practice Address - Street 1:270-05 76TH AVE.
Practice Address - Street 2:LIJ MEDICAL CENTER STAFF HOUSE ROOM 210B
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040
Practice Address - Country:US
Practice Address - Phone:718-470-4650
Practice Address - Fax:516-354-6491
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY2812192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry