Healthcare Provider Details

I. General information

NPI: 1861125825
Provider Name (Legal Business Name): AMNA HAIDER DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

43 WILMINGTON DR
MELVILLE NY
11747-4032
US

V. Phone/Fax

Practice location:
  • Phone: 443-997-5476
  • Fax:
Mailing address:
  • Phone: 631-312-1350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberH0107472
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: