Provider Demographics
NPI:1649429994
Name:MAHA AWIKEH, M.D. P.C.
Entity type:Organization
Organization Name:MAHA AWIKEH, M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MAHA
Authorized Official - Middle Name:
Authorized Official - Last Name:AWIKEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-921-0979
Mailing Address - Street 1:326 79 ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:718-921-0979
Mailing Address - Fax:718-921-1162
Practice Address - Street 1:326 79 ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-921-0979
Practice Address - Fax:718-921-1162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2008-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231058363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02726965Medicaid
307AF1Medicare PIN
NYI33338Medicare UPIN