MEDICARE: NABIL N. ABDELMALAK & MARY S. TAWFIK, PHYSICIANS, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	207L00000X	Anesthesiology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063562619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NABIL N. ABDELMALAK & MARY S. TAWFIK, PHYSICIANS, P.C.

Provider Business Mailing Address
First Line	:	PO BOX 270
Second Line	:
City	:	MASSAPEQUA PARK
State	:	NY
Zip	:	11762-0270
Country	:	US
Telephone Number	:	631-264-2035
Fax Number	:	631-264-1418

Provider Business Practice Location Address
First Line	:	1725 E 12TH ST
Second Line	:	SUITE 202
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1028
Country	:	US
Telephone Number	:	718-265-5858
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NABIL N ABDELMALAK
Credential	:	M.D.
Telephone Number	:	718-982-8074

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	10/26/2007

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