Healthcare Provider Details

I. General information

NPI: 1356036305
Provider Name (Legal Business Name): AMIR MEFTAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: AMIRMOHAMMAD MEFTAH MD

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1545 ATLANTIC AVE
BROOKLYN NY
11213-1122
US

IV. Provider business mailing address

99 BATTERY PL APT 24G
NEW YORK NY
10280-1328
US

V. Phone/Fax

Practice location:
  • Phone: 718-613-4334
  • Fax:
Mailing address:
  • Phone: 917-288-5540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number345473
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: