Provider Demographics
NPI:1801107594
Name:SHAKIR, MARIYUM A (MD)
Entity type:Individual
Prefix:DR
First Name:MARIYUM
Middle Name:A
Last Name:SHAKIR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:506 6TH ST
Mailing Address - Street 2:NEW YORK METHODIST HOSPITAL
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3609
Mailing Address - Country:US
Mailing Address - Phone:917-459-7602
Mailing Address - Fax:718-780-3259
Practice Address - Street 1:263 7TH AVE STE 5H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3690
Practice Address - Country:US
Practice Address - Phone:718-788-5050
Practice Address - Fax:718-768-2770
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2023-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA257574207R00000X
NY257574207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine