Provider Demographics
NPI:1073556437
Name:SHADY, MAGDY SHAWKY (MD)
Entity Type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:SHAWKY
Last Name:SHADY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2500 NESCONSET HWY
Mailing Address - Street 2:BUILDING 18C
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2555
Mailing Address - Country:US
Mailing Address - Phone:631-751-2700
Mailing Address - Fax:631-751-5853
Practice Address - Street 1:2500 NESCONSET HWY
Practice Address - Street 2:BUILDING 18C
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11790-2555
Practice Address - Country:US
Practice Address - Phone:631-751-2700
Practice Address - Fax:631-751-5853
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2014-12-08
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Provider Licenses
StateLicense IDTaxonomies
NY181099207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE75264Medicare UPIN
NY16G851Medicare PIN