Healthcare Provider Details

I. General information

NPI: 1841851417
Provider Name (Legal Business Name): SHERIF BAHAAELDIN ELSHERIF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 07/08/2025
Certification Date: 07/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

560 1ST AVE FL 2
NEW YORK NY
10016-6402
US

IV. Provider business mailing address

300 PASTEUR DR RM H1307
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 212-263-5230
  • Fax: 646-754-9560
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA192976
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License Number337643
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: