Provider Demographics
NPI:1962266486
Name:HARPAL, SHAVON HEMA I
Entity type:Individual
Prefix:
First Name:SHAVON
Middle Name:HEMA
Last Name:HARPAL
Suffix:I
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 1:2313 GLEASON AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-5303
Mailing Address - Country:US
Mailing Address - Phone:718-790-9154
Mailing Address - Fax:
Practice Address - Street 1:2313 GLEASON AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-5303
Practice Address - Country:US
Practice Address - Phone:718-790-9154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY112627104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker