MEDICARE: ANUM NASIR MITHA DO

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	2080P0204X	Pediatric Emergency Medicine (Pediatrics) Physician	338693	NY

General Provider Information

NPI Number	:	1639810831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANUM NASIR MITHA DO

Provider Business Mailing Address
First Line	:	MAIMONIDES MEDICAL CENTER
Second Line	:	4802 10TH AVENUE
City	:	BROOKLYN
State	:	NY
Zip	:	11219
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	MAIMONIDES MEDICAL CENTER
Second Line	:	4802 10TH AVENUE
City	:	BROOKLYN
State	:	NY
Zip	:	11219
Country	:	US
Telephone Number	:	516-477-6570
Fax Number	:

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

Provider Enumeration Date	:	04/05/2022
Last Update Date	:	02/24/2026

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