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General NPI Number Information
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NPI Number | 1679739551
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Entity Type | Individual
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Provider Name | AMGAD EMEAL BOTROS MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2008
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 1946 BATH AVE
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City | BROOKLYN
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State | NY
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Zip | 11214-4704
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Country | US
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Telephone | 718-360-0760
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Fax | 781-523-2482
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Provider Business Mailing Address
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Address Line | 66 SUGAR MAPLE DR
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City | ROSLYN
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State | NY
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Zip | 11576-3229
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Country | US
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Telephone | 917-907-2819
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Fax | 781-523-2482
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 0101284389
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 249822
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License Number State | NY
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