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Individual

DR. FAWAZ AHMED SAMI AL-MUFTI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 WOODS RD # A, VALHALLA, NY 10595-1530
(914) 493-7000
Mailing address
710 W 168TH ST, NEW YORK, NY 10032-3726
(212) 305-7236
(212) 305-2792

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
270440
NY
208D00000X
General Practice Physician
241152
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03782198
NY
01
270440
NYS LICENSE
NY
01
A400191607
MEDICARE
NY
Enumeration date
08/27/2009
Last updated
08/17/2018
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