Provider Demographics
NPI:1518965086
Name:MALIK, ASIM R (MD)
Entity Type:Individual
Prefix:
First Name:ASIM
Middle Name:R
Last Name:MALIK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:188 OLD WESTBURY RD
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-1100
Mailing Address - Country:US
Mailing Address - Phone:718-788-5588
Mailing Address - Fax:718-788-1484
Practice Address - Street 1:1224 8TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-5106
Practice Address - Country:US
Practice Address - Phone:718-788-5588
Practice Address - Fax:718-788-1484
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2013-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY141998207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00773120Medicaid
NYW34111Medicare ID - Type Unspecified
NYC12341Medicare UPIN
NY92A381Medicare ID - Type Unspecified