Healthcare Provider Details

I. General information

NPI: 1588341135
Provider Name (Legal Business Name): MOATH AHMAD SALMAN ALBLIWI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2023
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

665 ELM ST
BUFFALO NY
14203-1104
US

IV. Provider business mailing address

3327 MILLERSPORT HWY APT 304
GETZVILLE NY
14068-1634
US

V. Phone/Fax

Practice location:
  • Phone: 716-845-2300
  • Fax:
Mailing address:
  • Phone: 216-205-6118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number57.255134
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: