Provider Demographics
NPI:1255357034
Name:TAWFIK, MARY SALAH (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:SALAH
Last Name:TAWFIK
Suffix:
Gender:F
Credentials:MD
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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:718-806-1609
Mailing Address - Fax:718-806-1693
Practice Address - Street 1:585 SCHENECTADY AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-1822
Practice Address - Country:US
Practice Address - Phone:718-806-1609
Practice Address - Fax:718-806-1693
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2020-09-02
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Provider Licenses
StateLicense IDTaxonomies
NY215284207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53C021Medicare PIN
NYH05309Medicare UPIN