DR. KOMOLA AZIMOVA SHABAN (NPI# 1326495235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326495235 |
| Entity Type | Individual |
| Full Name | DR. KOMOLA AZIMOVA SHABAN |
| Other Name | DR. KOMOLA AZIMOVA |
| Credential | MD |
| Practice Address |
701 N Broadway Ste 405 Sleepy Hollow NY 10591-1020 |
| Practice Telephone | 9143665353 |
| Enumeration Date | 2016-05-20 |
| Last Update Date | 2018-06-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | NY | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1200 Old York Rd, Abington, PA 190013720 | 2154817464 |
| Street Address |
701 N BROADWAY STE 405 |
| City | SLEEPY HOLLOW |
| State | NY |
| Zip Code | 10591-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366974180 | Christie Ton | Family Medicine | 701 N Broadway Ste 405, Sleepy Hollow, NY 10591-1020 | 2017-03-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306451661 | Viviana Martinez | Counselor | 81 Fairview Avenue, Second Floor, Tarrytown, NY 10591 | 2020-09-14 |
| 1730718834 | Johnny Truong | Student in an Organized Health Care Education/Training Program | Phelps Family Medicine Residency Program, 701 North Broadway, Sleepy Hollow, NY 10591 | 2020-04-02 |
| 1336707314 | Jeffrey Edward Dwulet | Student in an Organized Health Care Education/Training Program | Phelps Memorial Hospital, 701 North Broadway, Sleepy Hollow, NY 10591 | 2019-06-04 |
| 1881188738 | Broadway Cosmetic Dentistry, P.C. | Dentist | 128 South Broadway, Tarrytown, NY 10591 | 2018-06-14 |
| 1356883870 | Kathryn Kearns | Early Intervention Provider Agency | 12 Francis Street, Sleepy Hollow, NY 10591 | 2016-11-15 |
| 1467802058 | Bv Tarrytown Operator LLC | Alzheimer Center (Dementia Center) | 581 Old White Plains Road, Tarrytown, NY 10591 | 2016-06-15 |
| 1316309347 | Harbor Dental | Public Health or Welfare | 55 River Street, Mei Zhang, Dds, Sleepy Hollow, NY 10591 | 2016-03-29 |
| 1770948317 | Hyra Kamecaj Zucker | Counselor | 55 Stephen Drive, Tarrytown, NY 10591 | 2015-12-28 |
| 1396137428 | Jerry Diaz | Health Educator | 173 1/2 Cortlandt St, Sleepy Hollow, NY 10591 | 2015-02-26 |
| 1740670397 | Heather Katz | Internal Medicine | 777 N Broadway Ste 102, Sleepy Hollow, NY 10591 | 2015-02-03 |
| Find all providers in zip 10591 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718834 | Johnny Truong | Student in an Organized Health Care Education/Training Program | Phelps Family Medicine Residency Program, 701 North Broadway, Sleepy Hollow, NY 10591 | 2020-04-02 |
| 1336707314 | Jeffrey Edward Dwulet | Student in an Organized Health Care Education/Training Program | Phelps Memorial Hospital, 701 North Broadway, Sleepy Hollow, NY 10591 | 2019-06-04 |
| 1235661166 | Lorraine Dogan | Student in an Organized Health Care Education/Training Program | 701 N Broadway # 2, Sleepy Hollow, NY 10591-1020 | 2017-03-30 |
| 1326660887 | Yvonne Liang | Student in an Organized Health Care Education/Training Program | 701 N Broadway, Sleepy Hollow, NY 10591-1096 | 2020-05-07 |
| 1518588920 | Melina Cherian Pooppallil | Student in an Organized Health Care Education/Training Program | 701 N Broadway, Sleepy Hollow, NY 10591-1020 | 2020-04-27 |
| 1629698428 | Hannah Slavin | Student in an Organized Health Care Education/Training Program | 701 North Broadway, Sleepy Hollow, NY 10591 | 2020-04-21 |
| 1972130409 | Peter Rasmussen | Student in an Organized Health Care Education/Training Program | 701 N Broadway, Sleepy Hollow, NY 10591-1020 | 2020-03-25 |
| 1851928220 | Amir Michael Razani | Student in an Organized Health Care Education/Training Program | 701 N Broadway, Sleepy Hollow, NY 10591-1020 | 2020-03-25 |
| 1124655758 | Jing Xiao | Student in an Organized Health Care Education/Training Program | 701 N Broadway, Sleepy Hollow, NY 10591-1020 | 2020-03-24 |
| 1801423793 | Justen Luis Molina | Student in an Organized Health Care Education/Training Program | 701 N Broadway, Sleepy Hollow, NY 10591-1020 | 2020-03-23 |
| Find all providers in SLEEPY HOLLOW | ||||
| City | SLEEPY HOLLOW |
| Zip Code | 10591 |
Please comment or provide details below to improve the information on DR. KOMOLA AZIMOVA SHABAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.