Provider Demographics
NPI:1548401391
Name:FAYYAZ A. SHEIKH PHYSICIAN PC
Entity Type:Organization
Organization Name:FAYYAZ A. SHEIKH PHYSICIAN PC
Other - Org Name:FAYYAZ A. SHEIKH M.D.P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAYYAZ
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:SHEIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-623-4180
Mailing Address - Street 1:274 S MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-3328
Mailing Address - Country:US
Mailing Address - Phone:845-623-4180
Mailing Address - Fax:845-623-4529
Practice Address - Street 1:274 S MIDDLETOWN RD
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-3328
Practice Address - Country:US
Practice Address - Phone:845-623-4180
Practice Address - Fax:845-623-4529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-07
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY132458207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W91601Medicare PIN