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General NPI Number Information
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NPI Number | 1699901561
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Entity Type | Organization
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Legal Business Name | ABDUL MALIK PHYSICIAN PC
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Dates
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Enumeration Date | 06/05/2009
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Last Update Date | 05/19/2011
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Provider Practice Location Address
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Address Line | 1 VILLADOM CT
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City | DIX HILLS
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State | NY
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Zip | 11746-5444
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Country | US
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Telephone | 718-469-4006
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Fax |
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Provider Business Mailing Address
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Address Line | 1 VILLADOM CT
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City | DIX HILLS
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State | NY
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Zip | 11746-5444
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Country | US
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Telephone | 718-469-4006
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ABDUL MALIK
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Credential | M.D.
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Telephone | 718-469-4006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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