Provider Demographics
NPI:1104939891
Name:NAYEL, AMR (MD)
Entity type:Individual
Prefix:DR
First Name:AMR
Middle Name:
Last Name:NAYEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 32
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-0032
Mailing Address - Country:US
Mailing Address - Phone:718-626-2700
Mailing Address - Fax:718-278-4921
Practice Address - Street 1:2138 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2661
Practice Address - Country:US
Practice Address - Phone:718-626-2700
Practice Address - Fax:718-278-4921
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205225207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY06V01ER851Medicare PIN
NY06334GMedicare PIN
NY02890Medicare PIN