MEDICARE: OMAR Y AMIN LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	340825	NY

General Provider Information

NPI Number	:	1811856248
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMAR Y AMIN LPN

Provider Business Mailing Address
First Line	:	1370 E 89TH ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5122
Country	:	US
Telephone Number	:	929-299-9508
Fax Number	:

Provider Business Practice Location Address
First Line	:	1370 E 89TH ST APT 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11236-5122
Country	:	US
Telephone Number	:	929-995-0875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2026
Last Update Date	:	01/21/2026

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