Provider Demographics
NPI:1184733149
Name:KARIM, RUKSHANA OMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RUKSHANA
Middle Name:OMAR
Last Name:KARIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTSON
Mailing Address - State:NY
Mailing Address - Zip Code:11507-1033
Mailing Address - Country:US
Mailing Address - Phone:516-621-8817
Mailing Address - Fax:718-760-4851
Practice Address - Street 1:9730 57TH AVE
Practice Address - Street 2:SUITE 1K
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368-3542
Practice Address - Country:US
Practice Address - Phone:718-271-3344
Practice Address - Fax:718-760-4851
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155586208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00826600Medicaid