Provider Demographics
NPI:1548423296
Name:IBRAHIM, CHERIF (MD)
Entity Type:Individual
Prefix:
First Name:CHERIF
Middle Name:
Last Name:IBRAHIM
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:PO BOX 928
Mailing Address - Street 2:MID ATLANTIC PATHOLOGY SERVICES, PA
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10940-4133
Mailing Address - Country:US
Mailing Address - Phone:845-346-0664
Mailing Address - Fax:
Practice Address - Street 1:60 PROSPECT AVENUE
Practice Address - Street 2:MID ATLANTIC PATHOLOGY SERVICES, PA/ORANGE REGIONAL MED
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-4133
Practice Address - Country:US
Practice Address - Phone:845-346-0664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT193288207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology