Healthcare Provider Details

I. General information

NPI: 1326131657
Provider Name (Legal Business Name): MOHAMED AMR AHMED HOSNY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 02/26/2022
Certification Date: 02/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 5TH AVE SUITE 1A/1B
NEW YORK NY
10003-4319
US

IV. Provider business mailing address

44 STATE RT 23 STE 15B
RIVERDALE NJ
07457-1603
US

V. Phone/Fax

Practice location:
  • Phone: 212-604-1300
  • Fax:
Mailing address:
  • Phone: 631-264-2035
  • Fax: 631-264-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LH0002X
TaxonomyHospice and Palliative Medicine (Anesthesiology) Physician
License Number228199
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number228199
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number228199
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: