Individual
DR. HANI LAOIZ SHAHATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2125 RIVER RD, SUITE 303, SCHENECTADY, NY 12309-1135
(518) 831-2500
(518) 831-2510
Mailing address
711 TROY SCHENECTADY RD STE 203, LATHAM, NY 12110-2461
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
242021
NY
207RN0300X
Nephrology Physician
Primary
242021
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001RZ1
EMPIRE BLUECROSS
NY
05
—
02831776
—
NY
05
—
02995513
—
NY
01
—
110625000012
FIDELIS
NY
01
—
308712
SENIOR WHOLE HEALTH
NY
01
—
649058
GHI-HMO
NY
01
—
9418120
AETNA
NY
Enumeration date
11/01/2006
Last updated
01/18/2018
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