Provider Demographics
NPI:1962237388
Name:SHARIFIAN, SHAINA N
Entity type:Individual
Prefix:
First Name:SHAINA
Middle Name:N
Last Name:SHARIFIAN
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 1:5 ALGER RD
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-1013
Mailing Address - Country:US
Mailing Address - Phone:516-522-1234
Mailing Address - Fax:
Practice Address - Street 1:15645 84TH ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2645
Practice Address - Country:US
Practice Address - Phone:718-464-5606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-05
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist