Provider Demographics
NPI:1679540173
Name:HEIBA, SHERIF (MD)
Entity Type:Individual
Prefix:
First Name:SHERIF
Middle Name:
Last Name:HEIBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:1141
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-5998
Mailing Address - Fax:212-241-2705
Practice Address - Street 1:1 GUSTAVE L LEVY PL
Practice Address - Street 2:1141
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-5998
Practice Address - Fax:212-241-2705
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-11-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY213637207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01978129Medicaid
NY90Z221Medicare ID - Type Unspecified
NY01978129Medicaid