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General NPI Number Information
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NPI Number | 1699379305
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Entity Type | Individual
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Provider Name | MOHAMMED AWAD MOHAMMED I ABDEEN MD
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Gender | Male
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 03/04/2025
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Provider Practice Location Address
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Address Line | 101 NICOLLS ROAD, HSC L4 RM 120 ZIP 8460
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City | STONY BROOK
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State | NY
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Zip | 11794-8460
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Country | US
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Telephone | 631-444-5400
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Fax |
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Provider Business Mailing Address
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Address Line | 101 NICOLLS ROAD, HSC LEVEL 4, ROOM 120
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City | STONY BROOK
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State | NY
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Zip | 11794-8460
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Country | US
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Telephone | 631-444-5400
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Fax | 631-444-7538
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 333908
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License Number State | NY
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