Basic Information
Provider Information
NPI: 1285659649
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALAM
FirstName: HAMID
MiddleName: M
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ALAM
OtherFirstName: H.M.
OtherMiddleName: MORSHEDUL
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: MD
OtherLastNameType: 1
Mailing Information
Address1: 52 MAIN ST
Address2:  
City: BEDFORD HILLS
State: NY
PostalCode: 105071814
CountryCode: US
TelephoneNumber: 9146662220
FaxNumber: 9146662987
Practice Location
Address1: 101 HOSPITAL RD
Address2:  
City: PATCHOGUE
State: NY
PostalCode: 117724870
CountryCode: US
TelephoneNumber: 9525951100
FaxNumber: 6122944903
Other Information
ProviderEnumerationDate: 07/13/2006
LastUpdateDate: 03/24/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X240456NYY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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