Provider Demographics
NPI:1417535527
Name:ABIDALI, HAYDER (DO)
Entity type:Individual
Prefix:
First Name:HAYDER
Middle Name:
Last Name:ABIDALI
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:299 E 161ST ST APT 902
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-2688
Mailing Address - Country:US
Mailing Address - Phone:602-688-1079
Mailing Address - Fax:409-217-3223
Practice Address - Street 1:234 E 149TH ST STE 2A5
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:602-688-1079
Practice Address - Fax:409-217-3223
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY333376207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine