Provider Demographics
NPI:1891799656
Name:SHEIKH, TARIQ A (MD)
Entity type:Individual
Prefix:
First Name:TARIQ
Middle Name:A
Last Name:SHEIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7060 ERIE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DERBY
Mailing Address - State:NY
Mailing Address - Zip Code:14047-9430
Mailing Address - Country:US
Mailing Address - Phone:716-947-0408
Mailing Address - Fax:716-947-0413
Practice Address - Street 1:7060 ERIE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DERBY
Practice Address - State:NY
Practice Address - Zip Code:14047-9430
Practice Address - Country:US
Practice Address - Phone:716-947-0408
Practice Address - Fax:716-947-0413
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY233142207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02564432Medicaid
NYRA2604Medicare ID - Type Unspecified
NYI11624Medicare UPIN