Basic Information
| Provider Information | |||||||||
| NPI: | 1902241151 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUSHMENDY | ||||||||
| FirstName: | SHAZAAN | ||||||||
| MiddleName: | FERSHID | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 47 NEW SCOTLAND AVENUE | ||||||||
| Address2: | DEPARTMENT OF ORTHOPEDIC SURGERY | ||||||||
| City: | ALBANY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5185986288 | ||||||||
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| Practice Location | |||||||||
| Address1: | 651 OLD COUNTRY RD DEPT OF | ||||||||
| Address2: | |||||||||
| City: | PLAINVIEW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 118034938 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166818822 | ||||||||
| FaxNumber: | 5166813332 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/01/2013 | ||||||||
| LastUpdateDate: | 07/02/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 63330 | NY | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207X00000X | 293711 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 63330 | 01 | NY | ALBANY MEDICAL CENTER | OTHER |