Healthcare Provider Details

I. General information

NPI: 1639416100
Provider Name (Legal Business Name): LENA SALIH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2013
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6805 5TH AVE
BROOKLYN NY
11220-6009
US

IV. Provider business mailing address

7609 4TH AVE F12
BROOKLYN NY
11209-3238
US

V. Phone/Fax

Practice location:
  • Phone: 718-833-7466
  • Fax:
Mailing address:
  • Phone: 917-870-7706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number265679
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: