Provider Demographics
NPI:1144418864
Name:HOBEIKA, PAUL BOULOS E (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:BOULOS E
Last Name:HOBEIKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1090 AMSTERDAM AVE
Mailing Address - Street 2:SUITE 9C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-1737
Mailing Address - Country:US
Mailing Address - Phone:212-663-4594
Mailing Address - Fax:212-316-6318
Practice Address - Street 1:1090 AMSTERDAM AVE
Practice Address - Street 2:SUITE 9C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-1737
Practice Address - Country:US
Practice Address - Phone:212-663-4594
Practice Address - Fax:212-316-6318
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY133556207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00752727Medicaid
NYB79532Medicare UPIN
NY80A061Medicare PIN