Healthcare Provider Details

I. General information

NPI: 1568491140
Provider Name (Legal Business Name): ALLIED HEALTHCARE PHYSICIAN PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 E BOSTON POST RD STE 201
MAMARONECK NY
10543
US

IV. Provider business mailing address

444 E BOSTON POST RD STE 201
MAMARONECK NY
10543-3704
US

V. Phone/Fax

Practice location:
  • Phone: 914-834-1777
  • Fax:
Mailing address:
  • Phone: 914-834-1777
  • Fax: 914-834-0047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number230232
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License Number
License Number State

VIII. Authorized Official

Name: EYAD M HIJAZIN
Title or Position: PRESIDENT
Credential: MD
Phone: 914-834-1777