Provider Demographics
NPI:1134470107
Name:ALKHAFAJI, NAWFAL (MD)
Entity Type:Individual
Prefix:
First Name:NAWFAL
Middle Name:
Last Name:ALKHAFAJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3719 UNION RD STE 218
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-4251
Mailing Address - Country:US
Mailing Address - Phone:716-206-1503
Mailing Address - Fax:716-651-9945
Practice Address - Street 1:3091 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14227-1919
Practice Address - Country:US
Practice Address - Phone:716-822-3098
Practice Address - Fax:716-819-1809
Is Sole Proprietor?:No
Enumeration Date:2012-09-30
Last Update Date:2019-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294455207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05278859Medicaid
NYJ400487879OtherMEDICARE