Basic Information
Provider Information
NPI: 1003150699
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAYED
FirstName: ABDUL
MiddleName: H
NamePrefix: MR.
NameSuffix:  
Credential: PA-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2 OHIO DR STE 201
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110421111
CountryCode: US
TelephoneNumber: 5166226105
FaxNumber: 5166226082
Practice Location
Address1: 2 OHIO DR STE 201
Address2:  
City: NEW HYDE PARK
State: NY
PostalCode: 110421111
CountryCode: US
TelephoneNumber: 5166226105
FaxNumber: 5166226082
Other Information
ProviderEnumerationDate: 11/20/2012
LastUpdateDate: 06/11/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/11/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X016259NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


Home