Healthcare Provider Details

I. General information

NPI: 1801709415
Provider Name (Legal Business Name): MUSTAFA K EL SAEED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6970 GRAND AVE
MASPETH NY
11378-1828
US

IV. Provider business mailing address

6970 GRAND AVE
MASPETH NY
11378-1828
US

V. Phone/Fax

Practice location:
  • Phone: 718-263-4600
  • Fax:
Mailing address:
  • Phone: 718-263-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1002X
TaxonomyPhysician Nutrition Specialist (Internal Medicine)
License NumberP146188
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: