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General NPI Number Information
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NPI Number | 1497745905
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Entity Type | Individual
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Provider Name | AHMED ADEL EL SOURY MD
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Gender | Male
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 251 RICHMOND HILL RD
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City | STATEN ISLAND
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State | NY
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Zip | 10314-5906
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Country | US
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Telephone | 718-761-2800
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Fax | 718-494-6829
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Provider Business Mailing Address
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Address Line | PO BOX 141280
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City | STATEN ISLAND
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State | NY
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Zip | 10314-1280
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Country | US
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Telephone | 718-761-2800
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Fax | 718-494-6829
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 60234547
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License Number State | NY
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