Provider Demographics
NPI:1306532270
Name:ELSHENAWI, KARIM TAREK ELSAYED
Entity type:Individual
Prefix:
First Name:KARIM
Middle Name:TAREK ELSAYED
Last Name:ELSHENAWI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 LAWTON AVE APT C2
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2432
Mailing Address - Country:US
Mailing Address - Phone:347-282-0882
Mailing Address - Fax:
Practice Address - Street 1:3406 BERGENLINE AVE
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-3922
Practice Address - Country:US
Practice Address - Phone:973-953-1540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04301300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist