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NPI Code Detail

MEDICARE: DR. MOHAMED S ALSALAHI M.D.

MEDICARE: DR. MOHAMED S ALSALAHI M.D.
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
1207RG0100XGastroenterology Physician237763NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00374128OTHERNYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1881605749
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MOHAMED S ALSALAHI M.D.
Provider Business Mailing Address
First Line : 1304 DRIVING PARK AVE
Second Line :
City : NEWARK
State : NY
Zip : 14513-1059
Country : US
Telephone Number : 315-359-2130
Fax Number : 315-359-2139
Provider Business Practice Location Address
First Line : 1304 DRIVING PARK AVE
Second Line :
City : NEWARK
State : NY
Zip : 14513-1059
Country : US
Telephone Number : 315-359-2130
Fax Number : 315-359-2139
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2006
Last Update Date : 04/19/2021

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