Provider Demographics
NPI:1477303931
Name:LAHAN, SHUBHAM (MD)
Entity type:Individual
Prefix:DR
First Name:SHUBHAM
Middle Name:
Last Name:LAHAN
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 1:1400 PELHAM PKWY S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1138
Mailing Address - Country:US
Mailing Address - Phone:718-696-2583
Mailing Address - Fax:718-881-5074
Practice Address - Street 1:1364 CLIFTON RD NE STE H-100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1138
Practice Address - Country:US
Practice Address - Phone:404-727-4310
Practice Address - Fax:404-712-0561
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-26
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program