Individual
ALLA ADI SHABTAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
1042 SOUTHERN BLVD, BRONX, NY 10459
(718) 542-0200
(718) 542-0201
Mailing address
1042 SOUTHERN BLVD, BRONX, NY 10459-3406
(718) 542-0200
(718) 542-0201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
011844
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1861692287
NPI
—
Enumeration date
07/24/2007
Last updated
09/05/2023
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