MEDICARE: FATIMA SHAFIQ M.D.

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1427846955
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FATIMA SHAFIQ M.D.

Provider Business Mailing Address
First Line	:	79-01 BROADWAY
Second Line	:	ELMHURST HOSPITAL INTERNAL MEDICINE RESIDENCY PROGRAM
City	:	ELMHURST QUEENS
State	:	NY
Zip	:	11373
Country	:	US
Telephone Number	:	718-334-3437
Fax Number	:

Provider Business Practice Location Address
First Line	:	79-01 BROADWAY
Second Line	:	ELMHURST HOSPITAL INTERNAL MEDICINE RESIDENCY PROGRAM
City	:	ELMHURST QUEENS
State	:	NY
Zip	:	11373
Country	:	US
Telephone Number	:	718-334-3437
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2025
Last Update Date	:	01/15/2026

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