Provider Demographics
NPI:1902241151
Name:HUSHMENDY, SHAZAAN FERSHID (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAZAAN
Middle Name:FERSHID
Last Name:HUSHMENDY
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 1:47 NEW SCOTLAND AVENUE
Mailing Address - Street 2:DEPARTMENT OF ORTHOPEDIC SURGERY
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208
Mailing Address - Country:US
Mailing Address - Phone:518-598-6288
Mailing Address - Fax:
Practice Address - Street 1:651 OLD COUNTRY RD DEPT OF
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4938
Practice Address - Country:US
Practice Address - Phone:516-681-8822
Practice Address - Fax:516-681-3332
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63330390200000X
NY293711207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY63330OtherALBANY MEDICAL CENTER