Basic Information
| Provider Information | |||||||||
| NPI: | 1275744583 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SALEEM | ||||||||
| FirstName: | OMAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1728 SUNRISE HWY | ||||||||
| Address2: | |||||||||
| City: | MERRICK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115663745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5169924700 | ||||||||
| FaxNumber: | 5169924700 | ||||||||
| Practice Location | |||||||||
| Address1: | 161 WILLIS AVE | ||||||||
| Address2: | |||||||||
| City: | MINEOLA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115012616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5162806645 | ||||||||
| FaxNumber: | 5164140273 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 11/13/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207XX0004X | 262068 | NY | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Foot and Ankle Surgery |
No ID Information.