Provider Demographics
NPI:1861285322
Name:ABDUSHAHID, RAFSANJANI IBN (MPA, MAA)
Entity type:Individual
Prefix:
First Name:RAFSANJANI
Middle Name:IBN
Last Name:ABDUSHAHID
Suffix:
Gender:M
Credentials:MPA, MAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 BLU RAIL WAY
Mailing Address - Street 2:
Mailing Address - City:PINEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28134-6621
Mailing Address - Country:US
Mailing Address - Phone:607-353-9368
Mailing Address - Fax:
Practice Address - Street 1:7113 BLU RAIL WAY UNIT B
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28134-6621
Practice Address - Country:US
Practice Address - Phone:607-353-9368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide