Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 181099 | NY |
NPI | 1073556437 |
---|---|
Provider Name | Dr. Magdy Shawky Shady |
First Address | Stony Brook, NY 11790-2555 |
Second Address | Stony Brook, NY 11790-2555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 08/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E75264 | (02) | NY |