Provider Demographics
NPI:1982625950
Name:BISHER AKIL MD A MEDICAL CORP
Entity Type:Organization
Organization Name:BISHER AKIL MD A MEDICAL CORP
Other - Org Name:BISHER AKIL MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER PRES
Authorized Official - Prefix:MR
Authorized Official - First Name:BISHER
Authorized Official - Middle Name:
Authorized Official - Last Name:AKIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-929-2629
Mailing Address - Street 1:155 W 19TH ST FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4121
Mailing Address - Country:US
Mailing Address - Phone:212-929-2629
Mailing Address - Fax:
Practice Address - Street 1:155 W 19TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4121
Practice Address - Country:US
Practice Address - Phone:212-929-2629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2363971332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
3350345OtherOTHER ID NUMBER-COMMERCIAL NUMBER