MEDICARE: SIFAT ARA AMEEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	403110-01	NY

General Provider Information

NPI Number	:	1073129649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIFAT ARA AMEEN

Provider Business Mailing Address
First Line	:	10 PEARL ST
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4611
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10 PEARL ST
Second Line	:
City	:	PORT CHESTER
State	:	NY
Zip	:	10573-4611
Country	:	US
Telephone Number	:	914-265-4061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/19/2020
Last Update Date	:	04/17/2021

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Directions to “ SIFAT ARA AMEEN ” Practice Location

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