Provider Demographics
NPI:1215995295
Name:SHAHEEN, DIANA S
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:S
Last Name:SHAHEEN
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 1:4035 DOVER RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44511-3511
Mailing Address - Country:US
Mailing Address - Phone:330-788-3650
Mailing Address - Fax:
Practice Address - Street 1:23 HICKORY TRACE DR
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:OH
Practice Address - Zip Code:44420-1036
Practice Address - Country:US
Practice Address - Phone:330-545-0343
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered372500000XNursing Service Related ProvidersChore Provider
Not Answered374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2361126Medicaid