1689716912 NPI number — RASHID A SHAIKH

Table of content: RASHID A SHAIKH (NPI 1689716912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689716912 NPI number — RASHID A SHAIKH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHAIKH
Provider First Name:
RASHID
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689716912
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 GREENTREE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MINEOLA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11501-2114
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-294-7495
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1713,UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-294-0700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  145274 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 231408 . This is a "WELLCARE OF NEWYORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00145274 . This is a "METROPLUS OF NEWYORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000048653 . This is a "AFFINITY OF NEWYORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00609123 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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