Provider Demographics
NPI:1134374127
Name:NAZIR, SHAFAT (MS)
Entity type:Individual
Prefix:
First Name:SHAFAT
Middle Name:
Last Name:NAZIR
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BIRCH RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10303-1748
Mailing Address - Country:US
Mailing Address - Phone:718-273-4608
Mailing Address - Fax:718-273-4608
Practice Address - Street 1:101 BIRCH RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10303-1748
Practice Address - Country:US
Practice Address - Phone:718-273-4608
Practice Address - Fax:718-273-4608
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015393235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist