Provider Demographics
NPI:1548561004
Name:MAKARYUS, SAMIA RAFIK (MD)
Entity Type:Individual
Prefix:
First Name:SAMIA
Middle Name:RAFIK
Last Name:MAKARYUS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:760 BROADWAY
Mailing Address - Street 2:PEDIATRIC DEPARTMENT
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8040
Mailing Address - Fax:718-630-3461
Practice Address - Street 1:760 BROADWAY
Practice Address - Street 2:PEDIATRIC DEPARTMENT
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8040
Practice Address - Fax:718-630-3461
Is Sole Proprietor?:No
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175532208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics