Organization
AHMED ALY ABDELFADIL PHYSICIAN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AHMED ALY ABDELFADIL M.D. (DIRECTOR)
(718) 761-2950
Entity
Organization
Contact information
Practice address
5947 AMBOY RD., SECOND FLOOR, STATEN ISLAND, NY 10309-3118
(718) 605-2970
(718) 605-7180
Mailing address
4 SQUAN SONG LANE, SECOND FLOOR, COLTS NECK, NJ 07722-1820
(718) 605-2970
(718) 605-7180
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
196563
NY
207RP1001X
Pulmonary Disease Physician
Primary
196563
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01993008
—
NY
01
—
8V3011
MEDICARE ID
NY
Enumeration date
08/11/2006
Last updated
04/25/2011
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