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General NPI Number Information
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NPI Number | 1437800117
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Entity Type | Individual
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Provider Name | DORON AMSALEM MD
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Gender | Male
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Dates
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Enumeration Date | 01/13/2022
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Last Update Date | 01/13/2022
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Provider Practice Location Address
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Address Line | 1051 RIVERSIDE DR
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City | NEW YORK
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State | NY
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Zip | 10032-1007
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Country | US
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Telephone | 646-774-8049
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Fax |
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Provider Business Mailing Address
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Address Line | 160 W 66TH ST APT 25A
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City | NEW YORK
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State | NY
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Zip | 10023-6559
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Country | US
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Telephone | 929-404-8802
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | P112193
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License Number State | NY
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