Provider Demographics
NPI:1154410488
Name:SHAMOON, HARRY (MD)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:
Last Name:SHAMOON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-6421
Mailing Address - Country:US
Mailing Address - Phone:718-405-8260
Mailing Address - Fax:718-405-8291
Practice Address - Street 1:MONTEFIORE MEDICAL PARK
Practice Address - Street 2:1575 BLONDELL AVENUE, STE. 200
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-405-8260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY131785207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism