Provider Demographics
NPI:1831451558
Name:REID, SASHEEN (PA)
Entity type:Individual
Prefix:
First Name:SASHEEN
Middle Name:
Last Name:REID
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:SASHEEN
Other - Middle Name:
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25811 147TH AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422-3318
Mailing Address - Country:US
Mailing Address - Phone:917-518-7662
Mailing Address - Fax:
Practice Address - Street 1:1825 EASTCHESTER ROAD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-904-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-08
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical