Healthcare Provider Details

I. General information

NPI: 1376460063
Provider Name (Legal Business Name): MOHAMMED KALIFA NUGUSE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 LENOX AVENUE DEPARTMENT OF EMERGENCY MEDICINE
NEW YORK CITY NY
10037
US

IV. Provider business mailing address

506 LENOX AVENUE DEPARTMENT OF EMERGENCY MEDICINE
NEW YORK CITY NY
10037
US

V. Phone/Fax

Practice location:
  • Phone: 212-939-2233
  • Fax:
Mailing address:
  • Phone: 212-939-2233
  • Fax: 212-939-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: