Healthcare Provider Details

I. General information

NPI: 1356139562
Provider Name (Legal Business Name): ABDULAZIZ IBRAHIM ALMOHAISIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2025
Last Update Date: 04/28/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 FORT WASHINGTON AVENUE HP8 875 DEPARTMENT OF OTOLARYNGOLOGY HEAD & NECK SURGERY VERONI
NEW YORK CITY NY
10032
US

IV. Provider business mailing address

PERSHORE STREET EAST TIMBER YARD FLAT 519 POST CODE B5 6AN
BIRMINGHAM UNITED KINGDOM
B56AN
GB

V. Phone/Fax

Practice location:
  • Phone: 212-305-9434
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberP134219
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License NumberP134219
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: