Healthcare Provider Details

I. General information

NPI: 1184184681
Provider Name (Legal Business Name): AIYA ABOUBAKR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

WEILL CORNELL INTERNAL MEDICINE ASSOCIATES 505 EAST 70TH STREET
NEW YORK NY
10021
US

IV. Provider business mailing address

WEILL CORNELL INTERNAL MEDICINE ASSOCIATES 505 EAST 70TH STREET
NEW YORK NY
10021
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-9663
  • Fax: 212-746-3609
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number311348
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: