Individual
AMR ETMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18901 NORTHERN BLVD, FLUSHING, NY 11358-2824
(917) 410-6905
(646) 878-6095
Mailing address
18901 NORTHERN BLVD, FLUSHING, NY 11358-2824
(917) 410-6905
(646) 878-6095
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
8029A
WY
207VG0400X
Gynecology Physician
0101257200
VA
207VG0400X
Gynecology Physician
Primary
275480-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101257200
LICENSE
VA
05
—
124781600
—
WY
01
—
307009
CHWHC MEDICARE
WY
01
—
8029A
WYOMING LICENSE#
WY
01
—
830306180
TAX ID
WY
Enumeration date
07/09/2008
Last updated
10/17/2024
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