Healthcare Provider Details

I. General information

NPI: 1114729423
Provider Name (Legal Business Name): DR AMIR SALEM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2025
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

372 CENTRAL PARK W APT 1D
NEW YORK NY
10025-8202
US

IV. Provider business mailing address

83 SPRING ST APT 5
NEW YORK NY
10012-3913
US

V. Phone/Fax

Practice location:
  • Phone: 212-516-8772
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: AMIR SALEM
Title or Position: OWNER
Credential:
Phone: 212-516-8772