Basic Information
| Provider Information | |||||||||
| NPI: | 1023052982 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHAKIBAIE SMITH | ||||||||
| FirstName: | SHABNAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 WEST END AVENUE | ||||||||
| Address2: | SUITE 1N | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2123052330 | ||||||||
| FaxNumber: | 2123054724 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 W END AVE STE IN | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100235601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6466209158 | ||||||||
| FaxNumber: | 8779194362 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/15/2006 | ||||||||
| LastUpdateDate: | 12/20/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 239512 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.