Provider Demographics
NPI:1104558758
Name:SHAY, SABINA
Entity type:Individual
Prefix:
First Name:SABINA
Middle Name:
Last Name:SHAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 TECHNOLOGY PKWY STE 201
Mailing Address - Street 2:
Mailing Address - City:MECHANICSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17050-9422
Mailing Address - Country:US
Mailing Address - Phone:717-221-5940
Mailing Address - Fax:717-233-1939
Practice Address - Street 1:2035 TECHNOLOGY PKWY STE 201
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17050-9422
Practice Address - Country:US
Practice Address - Phone:717-221-5940
Practice Address - Fax:717-233-1939
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-30
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026233363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty