Provider Demographics
NPI:1992798797
Name:ABBASI, SHABBIR A (MD)
Entity type:Individual
Prefix:
First Name:SHABBIR
Middle Name:A
Last Name:ABBASI
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:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:800-225-8885
Mailing Address - Fax:508-334-8105
Practice Address - Street 1:50 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-2238
Practice Address - Country:US
Practice Address - Phone:978-466-2411
Practice Address - Fax:978-466-2418
Is Sole Proprietor?:No
Enumeration Date:2005-08-26
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA204512084N0400X
NH109242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0021255OtherNHP
MAJ22690OtherBCBSMA
MA0100897Medicaid
MA204510OtherTHP
MA0858936001OtherCIGNA
NH30203395Medicaid
MA51111OtherFCHP
MA7699236OtherAETNA
NH01Y003569MA01OtherANTHEM
MA111099OtherHPHC
MA0021255OtherNHP
MA0100897Medicaid
MAA31201Medicare ID - Type Unspecified