# MEDICAL OFFICE OF FAWZY WASFY SALAMA PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467823443
- **Authorized official:** DEBRA COANE (OFFICE MANAGER)
- **Authorized official phone:** (631) 681-4754

## Contact information

- **Practice address:** 175 JERICHO TPKE, SUITE 411, SYOSSET, NY 11791-4532
- **Practice address phone:** (516) 558-7353
- **Practice address fax:** (631) 893-4020
- **Mailing address:** 175 JERICHO TPKE, SUITE 411, SYOSSET, NY 11791-4532

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084A0401X | Addiction Medicine (Psychiatry & Neurology) Physician | 197603 | NY | Yes |

## Other

- **Enumeration date:** 10/15/2015
- **Last updated:** 10/15/2015