Provider Demographics
NPI:1215240429
Name:AL-AWWAD, OMAR (MD)
Entity type:Individual
Prefix:
First Name:OMAR
Middle Name:
Last Name:AL-AWWAD
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 1:50 DAYTON LN STE 202
Mailing Address - Street 2:THE WESTCHESTER MEDICAL PRACTICE PC
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2860
Mailing Address - Country:US
Mailing Address - Phone:914-739-0087
Mailing Address - Fax:914-737-1714
Practice Address - Street 1:1980 CROMPOND RD
Practice Address - Street 2:THE WESTCHESTER MEDICAL PRACTICE PC
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4144
Practice Address - Country:US
Practice Address - Phone:914-734-3600
Practice Address - Fax:914-734-3601
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NY271169208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program