Healthcare Provider Details

I. General information

NPI: 1598693954
Provider Name (Legal Business Name): MUHAMMAD OMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 DUBOIS STREET, MONTEFIORE ST LUKE'S CORNWALL
NEWBURGH NY
12550
US

IV. Provider business mailing address

70 DUBOIS STREET, MONTEFIORE ST LUKE'S CORNWALL
NEWBURGH NY
12550
US

V. Phone/Fax

Practice location:
  • Phone: 845-568-2189
  • Fax:
Mailing address:
  • Phone: 845-568-2189
  • Fax:

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: