Provider Demographics
NPI:1386689511
Name:AWIKEH, MAHA (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHA
Middle Name:
Last Name:AWIKEH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 79TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-3610
Mailing Address - Country:US
Mailing Address - Phone:718-921-0979
Mailing Address - Fax:718-921-1162
Practice Address - Street 1:326 79TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-3610
Practice Address - Country:US
Practice Address - Phone:718-921-0979
Practice Address - Fax:718-921-1162
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231058207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY133338Medicare UPIN
NY307AF1Medicare ID - Type Unspecified