Provider Demographics
NPI:1326487513
Name:SALEM, AMIR N (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:N
Last Name:SALEM
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 1:16203 JAMAICA AVE STE 200A
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-4909
Mailing Address - Country:US
Mailing Address - Phone:347-390-1075
Mailing Address - Fax:718-301-1099
Practice Address - Street 1:16203 JAMAICA AVE STE 200A
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:347-390-1075
Practice Address - Fax:718-301-1099
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2927142085R0202X, 2085R0204X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program