Individual provider Active NPI

Tahani Shihadeh

  • Early Intervention Provider Agency
  • Bronx, NY
National Provider Identifier
1093425803
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Practice address
860 Melrose Ave FRNT 2L
Bronx, NY 10451-5757
Phone
(917) 473-6996
NPI assigned
Dec 2, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

860 Melrose Ave FRNT 2L
Bronx, NY 10451-5757

Mailing address

860 Melrose Ave FRNT 2L
Bronx, NY 10451-5757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1093425803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 MELROSE AVE FRNT 2L",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 MELROSE AVE FRNT 2L",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104515757",
            "telephone_number": "917-473-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIHADEH",
        "first_name": "TAHANI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-02",
        "last_updated": "2025-09-11",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.