MEDICARE: SHAIK ABUBAKAR MD

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	207Q00000X	Family Medicine Physician	MA053582	NJ

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	:	1578558847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAIK ABUBAKAR MD

Provider Business Mailing Address
First Line	:	452 CENTRAL AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-2727
Country	:	US
Telephone Number	:	201-222-0821
Fax Number	:	201-222-1018

Provider Business Practice Location Address
First Line	:	452 CENTRAL AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07307-2727
Country	:	US
Telephone Number	:	201-222-0821
Fax Number	:	201-222-1018

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

Provider Enumeration Date	:	09/13/2005
Last Update Date	:	07/08/2007

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