Provider Demographics
NPI:1992943062
Name:ABDULLAH MEDICAL PC
Entity type:Organization
Organization Name:ABDULLAH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDULLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-664-8000
Mailing Address - Street 1:43 STRATTON RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7552
Mailing Address - Country:US
Mailing Address - Phone:912-664-8000
Mailing Address - Fax:914-664-2416
Practice Address - Street 1:12 N 7TH AVE FL 5
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2026
Practice Address - Country:US
Practice Address - Phone:914-664-8000
Practice Address - Fax:914-664-2416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219201-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWCW311Medicare PIN