Provider Demographics
NPI:1083898233
Name:WAHIB, KARIM (PA-C, AT-C)
Entity Type:Individual
Prefix:MR
First Name:KARIM
Middle Name:
Last Name:WAHIB
Suffix:
Gender:M
Credentials:PA-C, AT-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 E 83RD ST
Mailing Address - Street 2:SUITE1 B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-1122
Mailing Address - Country:US
Mailing Address - Phone:646-942-8566
Mailing Address - Fax:
Practice Address - Street 1:120 E 83RD ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-1122
Practice Address - Country:US
Practice Address - Phone:646-248-0831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-24
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008291363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical