Provider Demographics
NPI:1235718966
Name:ABDULKARIM, FAWAZ R (DO STUDENT)
Entity Type:Individual
Prefix:
First Name:FAWAZ
Middle Name:R
Last Name:ABDULKARIM
Suffix:
Gender:M
Credentials:DO STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 BARNES AVE APT 21S
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-1995
Mailing Address - Country:US
Mailing Address - Phone:914-441-6444
Mailing Address - Fax:
Practice Address - Street 1:2707 BARNES AVE APT 21S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-1995
Practice Address - Country:US
Practice Address - Phone:914-441-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-08
Last Update Date:2021-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program