Individual
USAMA SHAPPAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T
Contact information
Practice address
684 83RD ST # 2, BROOKLYN, NY 11228-2816
(347) 993-1270
Mailing address
684 83RD ST # 2, BROOKLYN, NY 11228-2816
(347) 993-1270
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
017152-1
NY
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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