MEDICARE: GIBRAN SHAIKH M.D

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	207N00000X	Dermatology Physician	309730	NY

General Provider Information

NPI Number	:	1356871263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GIBRAN SHAIKH M.D

Provider Business Mailing Address
First Line	:	301 HICKS ST #4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201
Country	:	US
Telephone Number	:	832-766-4074
Fax Number	:

Provider Business Practice Location Address
First Line	:	278 COURT ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-4432
Country	:	US
Telephone Number	:	212-385-3700
Fax Number	:

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

Provider Enumeration Date	:	06/13/2017
Last Update Date	:	12/13/2021

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