Provider Demographics
NPI:1063248904
Name:SHAHBAZIAN, JOSEPH (DR)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:SHAHBAZIAN
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:446 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-2621
Mailing Address - Country:US
Mailing Address - Phone:857-600-2467
Mailing Address - Fax:
Practice Address - Street 1:446 BROADWAY
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-2621
Practice Address - Country:US
Practice Address - Phone:857-600-2467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide