Provider Demographics
NPI:1982713871
Name:SHABSIGH, RIDWAN (MD)
Entity type:Individual
Prefix:
First Name:RIDWAN
Middle Name:
Last Name:SHABSIGH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 FORT WASHINGTON AVE
Mailing Address - Street 2:11TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3729
Mailing Address - Country:US
Mailing Address - Phone:212-305-0123
Mailing Address - Fax:212-305-0116
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-0123
Practice Address - Fax:212-305-0116
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY183329174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2099285OtherAETNA
4289542OtherCIGNA
NS1283OtherOXFORD
55T711OtherEMPIRE BCBS
NY66F681Medicare ID - Type Unspecified
55T711OtherEMPIRE BCBS