Provider Demographics
NPI:1639244221
Name:NABIL N ABDELMALAK AND MARY S TAWFIK PC
Entity Type:Organization
Organization Name:NABIL N ABDELMALAK AND MARY S TAWFIK PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:N
Authorized Official - Last Name:ABDELMALAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-982-8074
Mailing Address - Street 1:46 STEPHEN LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10314-4863
Mailing Address - Country:US
Mailing Address - Phone:718-982-8074
Mailing Address - Fax:718-982-5077
Practice Address - Street 1:46 STEPHEN LOOP
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-4863
Practice Address - Country:US
Practice Address - Phone:718-982-8074
Practice Address - Fax:718-982-5077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215765207L00000X
NY215284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherTAX ID
NY=========OtherTAX ID