1790030153 NPI number — AHMED MAGED ALABBADY MD.

Table of content: AHMED MAGED ALABBADY MD. (NPI 1790030153)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790030153 NPI number — AHMED MAGED ALABBADY MD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALABBADY
Provider First Name:
AHMED
Provider Middle Name:
MAGED
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ALABBADY
Provider Other First Name:
AHMED
Provider Other Middle Name:
MAGED HASAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1790030153
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/15/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 GRAND ST FL 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WARWICK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10990-1035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-987-3906
Provider Business Mailing Address Fax Number:
845-987-5979

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 LIBERTY SQUARE MALL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STONY POINT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10980-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-942-1001
Provider Business Practice Location Address Fax Number:
845-942-1431
Provider Enumeration Date:
07/20/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MT201632 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 0101269178 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208600000X , with the licence number: MT201632 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X , with the licence number: 317265 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 07242299 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".