Provider Demographics
NPI:1285665695
Name:SHAKER, ELHAMY IBRAHIM (MD)
Entity Type:Individual
Prefix:DR
First Name:ELHAMY
Middle Name:IBRAHIM
Last Name:SHAKER
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 1:147 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4407
Mailing Address - Country:US
Mailing Address - Phone:201-287-1010
Mailing Address - Fax:201-287-9049
Practice Address - Street 1:147 CEDAR LN
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4407
Practice Address - Country:US
Practice Address - Phone:201-287-1010
Practice Address - Fax:201-287-9049
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA055823207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine