Healthcare Provider Details

I. General information

NPI: 1417434010
Provider Name (Legal Business Name): AMNA ASIF MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2018
Last Update Date: 10/05/2021
Certification Date: 10/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 GRAND CONCOURSE
BRONX NY
10457-7606
US

IV. Provider business mailing address

1650 SELWYN AVENUE SUITE 8B NEONATOLOGY DEPT.
BRONX NY
10457
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-2648
  • Fax:
Mailing address:
  • Phone: 718-579-2647
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number311361
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: