MEDICARE: DR. MOEEN HASAN SHEIKH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	035679	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144313545
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOEEN HASAN SHEIKH

Provider Business Mailing Address
First Line	:	352 SAINT PAULS AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2126
Country	:	US
Telephone Number	:	718-745-8295
Fax Number	:	718-745-9899

Provider Business Practice Location Address
First Line	:	5702 6TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-3805
Country	:	US
Telephone Number	:	718-745-8295
Fax Number	:	718-745-9899

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2006
Last Update Date	:	04/24/2015

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