Healthcare Provider Details

I. General information

NPI: 1154044634
Provider Name (Legal Business Name): AHMED MOKHTAR MAHMOUD ELBAYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1539 FRANKLIN AVE STE 103
MINEOLA NY
11501-4806
US

IV. Provider business mailing address

1539 FRANKLIN AVE STE 103
MINEOLA NY
11501-4806
US

V. Phone/Fax

Practice location:
  • Phone: 646-820-9289
  • Fax:
Mailing address:
  • Phone: 646-820-9289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number35.146046
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number317298
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD61292880
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License NumberMD61292880
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number91699
License Number StateGA
# 6
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35.146046
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number91699
License Number StateGA
# 8
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number35.146046
License Number StateOH
# 9
Primary TaxonomyN
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number317298
License Number StateNY
# 10
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License NumberMD61292880
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: