Provider Demographics
NPI:1629225651
Name:SHARAIHA, TALAL ZIAD (MD)
Entity type:Individual
Prefix:DR
First Name:TALAL
Middle Name:ZIAD
Last Name:SHARAIHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 W 72ND ST
Mailing Address - Street 2:APT 5C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2657
Mailing Address - Country:US
Mailing Address - Phone:215-531-3469
Mailing Address - Fax:
Practice Address - Street 1:375 SEGUINE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3932
Practice Address - Country:US
Practice Address - Phone:718-226-6902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-21
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051624207R00000X
PAMT193122207R00000X
NY278936208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist