Provider Demographics
NPI:1699078154
Name:MORRIS A. SHAMAH, M.D., P.C.
Entity type:Organization
Organization Name:MORRIS A. SHAMAH, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAMAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-627-2400
Mailing Address - Street 1:1636 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1100
Mailing Address - Country:US
Mailing Address - Phone:718-627-2400
Mailing Address - Fax:718-382-4493
Practice Address - Street 1:1636 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1100
Practice Address - Country:US
Practice Address - Phone:718-627-2400
Practice Address - Fax:718-382-4493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-06
Last Update Date:2010-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101383207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00174378Medicaid
B87501Medicare UPIN
909461Medicare PIN