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Individual

KAREEM ELTAKI ELTAKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
255 LAFAYETTE AVE, SUFFERN, NY 10901-4812
(845) 368-5000
(845) 357-5777
Mailing address
100 ROUTE 59, SUITE 105, SUFFERN, NY 10901-4927
(845) 357-5775
(845) 357-5777

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
25MA08345400
NJ
207L00000X
Anesthesiology Physician
Primary
266300-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0165476
NJ
05
03016373
NY
01
125458
MEDICARE
01
P00748634
RAILROAD MEDICARE
Enumeration date
04/17/2008
Last updated
10/25/2012
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