Provider Demographics
NPI:1255501250
Name:ABDEL-MISIH, SHERIF RAAFAT ZIKRY (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERIF
Middle Name:RAAFAT ZIKRY
Last Name:ABDEL-MISIH
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:PO BOX 1559
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-0989
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:HSC LEVEL 18 ROOM 065
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-3502
Practice Address - Country:US
Practice Address - Phone:631-444-8086
Practice Address - Fax:631-444-7871
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.0919762086X0206X
NY297990-12086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3076951Medicaid
OHAB4293271Medicare PIN