MEDICARE: MR. EDWARD AMELEMAH MD

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	207V00000X	Obstetrics & Gynecology Physician	230652	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609816578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. EDWARD AMELEMAH MD

Provider Business Mailing Address
First Line	:	107 W 4TH ST
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550-4002
Country	:	US
Telephone Number	:	914-699-7200
Fax Number	:	914-699-0837

Provider Business Practice Location Address
First Line	:	107 WEST 4TH STREET
Second Line	:
City	:	MOUNT VERNON
State	:	NY
Zip	:	10550
Country	:	US
Telephone Number	:	914-699-7200
Fax Number	:	914-699-0837

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	05/18/2026

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