Provider Demographics
NPI:1992971998
Name:SHOUKRI TEWFIK MD PC
Entity type:Organization
Organization Name:SHOUKRI TEWFIK MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-825-0221
Mailing Address - Street 1:9004 156TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-2718
Mailing Address - Country:US
Mailing Address - Phone:646-431-8651
Mailing Address - Fax:
Practice Address - Street 1:9004 156TH AVE
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-2718
Practice Address - Country:US
Practice Address - Phone:646-431-8651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY166487207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06497Medicare PIN
NYWLN151Medicare PIN
NY66E432Medicare PIN