Shabana Rahim, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

029808 Issued in NY

Practice address

13625 218TH St
Laurelton, NY 11413-2226

Phone

(718) 479-3753

NPI assigned

Mar 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1104573302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15012 129TH ST",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114204249",
            "telephone_number": "347-229-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13625 218TH ST",
            "city": "LAURELTON",
            "state": "NY",
            "postal_code": "114132226",
            "telephone_number": "718-479-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHIM",
        "first_name": "SHABANA",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NY",
            "license": "029808",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "srahim@merrickacademy.org",
            "affiliation": "N",
            "address_1": "13625 218th St",
            "city": "Laurelton",
            "state": "NY",
            "country_code": "US",
            "postal_code": "114132226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Speech-Language Pathologist in Laurelton, NY
• Providers in Laurelton, NY by specialty
• Speech-Language Pathologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.