Provider Demographics
NPI:1124584669
Name:PARADISE, SHOHANA AFROZ (CNP)
Entity type:Individual
Prefix:
First Name:SHOHANA
Middle Name:AFROZ
Last Name:PARADISE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:SHOHANA
Other - Middle Name:
Other - Last Name:AFROZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 MYRON ST STE A
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-1485
Mailing Address - Country:US
Mailing Address - Phone:413-592-1980
Mailing Address - Fax:
Practice Address - Street 1:17 PARADISE RD # 1020
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4229
Practice Address - Country:US
Practice Address - Phone:469-915-4211
Practice Address - Fax:888-660-0859
Is Sole Proprietor?:No
Enumeration Date:2019-02-20
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2286231363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health