Healthcare Provider Details

I. General information

NPI: 1881190023
Provider Name (Legal Business Name): MARWA ELDIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 GREENWICH ST RM 510
NEW YORK NY
10007-5511
US

IV. Provider business mailing address

255 GREENWICH ST RM 510
NEW YORK NY
10007-5511
US

V. Phone/Fax

Practice location:
  • Phone: 212-298-2720
  • Fax:
Mailing address:
  • Phone: 212-298-2759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number310983-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: