Provider Demographics
NPI:1588743207
Name:ZAHRA SHAFAEE, MD, PC
Entity type:Organization
Organization Name:ZAHRA SHAFAEE, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE INCORPORATOR, DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFAEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-634-5363
Mailing Address - Street 1:1160 MIDLAND AVE APT 10C
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6428
Mailing Address - Country:US
Mailing Address - Phone:914-202-9383
Mailing Address - Fax:914-202-9382
Practice Address - Street 1:1 VALLEY HEALTH PLZ
Practice Address - Street 2:LUCKOW PAVILLION, 2ND FLOOR
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3628
Practice Address - Country:US
Practice Address - Phone:201-634-5383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA081381002086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty