Basic Information
Provider Information
NPI: 1609045194
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AMIN SALEM
FirstName: HUSSEIN
MiddleName: K
NamePrefix: MR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 E 210TH STREET
Address2:  
City: BRONX
State: NY
PostalCode: 10467
CountryCode: US
TelephoneNumber: 7184058020
FaxNumber:  
Practice Location
Address1: 141 SOUTH CENTRAL AVENUE
Address2:  
City: HARTSDALE
State: NY
PostalCode: 10530
CountryCode: US
TelephoneNumber: 9149971060
FaxNumber: 9149971099
Other Information
ProviderEnumerationDate: 02/28/2008
LastUpdateDate: 02/28/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207VE0102X107232NYY Allopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology

No ID Information.


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