Healthcare Provider Details

I. General information

NPI: 1639733066
Provider Name (Legal Business Name): AMEENAT ALAO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

517 CONCORD AVE
BRONX NY
10455-4507
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5725
  • Fax:
Mailing address:
  • Phone: 586-480-9836
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number345660
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: