Provider Demographics
NPI:1407513195
Name:SHEIKH, BISMA M
Entity Type:Individual
Prefix:
First Name:BISMA
Middle Name:M
Last Name:SHEIKH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BIRCHWOOD DR W
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1940
Mailing Address - Country:US
Mailing Address - Phone:917-327-3777
Mailing Address - Fax:
Practice Address - Street 1:2325 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-2056
Practice Address - Country:US
Practice Address - Phone:718-225-6464
Practice Address - Fax:718-225-9316
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY383295363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics