Healthcare Provider Details

I. General information

NPI: 1164405262
Provider Name (Legal Business Name): HAMID I LALANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 03/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 108TH ST
CORONA NY
11368-4176
US

IV. Provider business mailing address

2801 EMMONS AVE APT 6B
BROOKLYN NY
11235-2276
US

V. Phone/Fax

Practice location:
  • Phone: 718-406-9032
  • Fax:
Mailing address:
  • Phone: 718-663-1853
  • Fax: 917-246-4461

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number130836
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: