Provider Demographics
NPI:1841497195
Name:SHAKERANEH, ESHAN (PHD)
Entity type:Individual
Prefix:
First Name:ESHAN
Middle Name:
Last Name:SHAKERANEH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 KING ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3258
Mailing Address - Country:US
Mailing Address - Phone:413-584-6855
Mailing Address - Fax:
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-3638
Practice Address - Country:US
Practice Address - Phone:413-584-6855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist