MEDICARE: ABU TALEB

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	332B00000X	Durable Medical Equipment & Medical Supplies		NY

General Provider Information

NPI Number	:	1215894787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABU TALEB

Provider Business Mailing Address
First Line	:	549 N RAILROAD AVE APT 1
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-3921
Country	:	US
Telephone Number	:	340-825-6317
Fax Number	:

Provider Business Practice Location Address
First Line	:	549 N RAILROAD AVE APT 1
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-3921
Country	:	US
Telephone Number	:	340-825-6317
Fax Number	:

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

Provider Enumeration Date	:	01/07/2026
Last Update Date	:	01/07/2026

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Directions to “ ABU TALEB ” Practice Location

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