Active NPI
Shirin Shokooh
- Psychiatry Physician
- New Haven, CT
National Provider Identifier
1477906642
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 21407
- Practice address
- 34 Park St
New Haven, CT 06519-1109 - Phone
- (203) 974-5832
- NPI assigned
- Jul 22, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 21407 | PR | Primary |
Addresses
Primary practice location
34 Park St
New Haven, CT 06519-1109
Mailing address
34 Park St
New Haven, CT 06519-1109
Phone (203) 974-5238
Other practice location 1
School of Medicine
University of Puerto Rico, Medical Sciences Campus
San Juan, PR 00936-5067
Phone (787) 758-7910
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21407 | PR | MD | Psychiatry Physician |
Interoperability endpoints
- sshokooh578484@direct.ynhh.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1469145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627516800000",
"number": "1477906642",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191109",
"telephone_number": "203-974-5238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 PARK ST",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065191109",
"telephone_number": "203-974-5832"
}
],
"practiceLocations": [
{
"address_1": "School of Medicine",
"address_2": "University of Puerto Rico, Medical Sciences Campus",
"address_purpose": "LOCATION",
"city": "San Juan",
"state": "PR",
"postal_code": "009365067",
"country_code": "US",
"telephone_number": "787-758-7910",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SHOKOOH",
"first_name": "SHIRIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-22",
"last_updated": "2021-07-29",
"certification_date": "2021-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PR",
"license": "21407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.