Provider Demographics
NPI:1750751236
Name:MISHRIKY INC
Entity type:Organization
Organization Name:MISHRIKY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:MISHRIKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-718-4598
Mailing Address - Street 1:16 CORNWALLIS CT
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-7917
Mailing Address - Country:US
Mailing Address - Phone:732-718-4598
Mailing Address - Fax:
Practice Address - Street 1:230 HILTON AVE STE 215
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-8116
Practice Address - Country:US
Practice Address - Phone:526-565-5556
Practice Address - Fax:516-483-0396
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241400207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02880817Medicaid
NY070805000005OtherFIDELIS
NY02880817Medicaid