Individual
ANJUMON A AMIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
550 MONTAUK HIGHWAY, SHIRLEY, NY 11967
(631) 852-1001
(631) 852-1122
Mailing address
19 OAKDALE AVE, FARMINGVILLE, NY 11738
(631) 736-8589
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
196797
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01770167
—
NY
01
—
370008547
RR
—
Enumeration date
08/05/2006
Last updated
12/19/2011
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