Healthcare Provider Details

I. General information

NPI: 1285321257
Provider Name (Legal Business Name): SUFYAN RAZAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: SUFYAN SHAIKH MD

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 10/26/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TURNPIKE, EAST MEADOW
NEW YORK NY
11554
US

IV. Provider business mailing address

2201 HEMPSTEAD TURNPIKE, EAST MEADOW
NEW YORK NY
11554
US

V. Phone/Fax

Practice location:
  • Phone: 516-572-6501
  • Fax:
Mailing address:
  • Phone: 516-572-6501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: