Provider Demographics
NPI:1780798637
Name:ARSHAD, SHAHANA (MD)
Entity type:Individual
Prefix:
First Name:SHAHANA
Middle Name:
Last Name:ARSHAD
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 1:2 COULTER ROAD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:14432
Mailing Address - Country:US
Mailing Address - Phone:315-462-1530
Mailing Address - Fax:315-462-5483
Practice Address - Street 1:2 COULTER ROAD
Practice Address - Street 2:
Practice Address - City:CLIFTON SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:14432
Practice Address - Country:US
Practice Address - Phone:315-462-1530
Practice Address - Fax:315-462-5483
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197182207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
101542BSOtherPREFERRED CARE
1109OtherROCHESTER BLUE SHIELD
NY460002091OtherRAILROAD MEDICARE
NYP010197182OtherBLUE CROSS BLUE SHIELD
P010197182OtherBLUE CHOICE
460002091OtherRAILROAD MEDICARE
NY01810833Medicaid
NY197182OtherPREFERRED CARE
010197182OtherRMSCO
NY1810833Medicaid
460002091OtherRAILROAD MEDICARE
010197182OtherRMSCO
NY01810833Medicaid