Provider Demographics
NPI:1043974389
Name:ELSHEIKH, ANN M (PA-C)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:M
Last Name:ELSHEIKH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2276 NEW YORK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4254
Mailing Address - Country:US
Mailing Address - Phone:631-478-9703
Mailing Address - Fax:
Practice Address - Street 1:752 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3900
Practice Address - Country:US
Practice Address - Phone:631-470-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363A00000X
NY027236207VX0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics