Healthcare Provider Details

I. General information

NPI: 1205730025
Provider Name (Legal Business Name): EMANOIL SHAFIK PODIATRY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SOUTHWOOD DR
OLD BRIDGE NJ
08857-1461
US

IV. Provider business mailing address

55 SOUTHWOOD DR
OLD BRIDGE NJ
08857-1461
US

V. Phone/Fax

Practice location:
  • Phone: 347-576-4417
  • Fax:
Mailing address:
  • Phone: 347-576-4417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. EMANOIL MAGDY SHAFIK
Title or Position: PODIATRIST
Credential: DPM
Phone: 347-576-4417