Basic Information
| Provider Information | |||||||||
| NPI: | 1467409151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAMOON | ||||||||
| FirstName: | ADEL | ||||||||
| MiddleName: | Y | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 775 MILL ST | ||||||||
| Address2: | |||||||||
| City: | MARION | ||||||||
| State: | MA | ||||||||
| PostalCode: | 027382201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186163440 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2601 OCEAN PKWY | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112357745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186163440 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 210312 | MA | Y | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.