Provider Demographics
NPI:1407934839
Name:SITAFALWALLA, AMIR (MD,FACEP)
Entity Type:Individual
Prefix:DR
First Name:AMIR
Middle Name:
Last Name:SITAFALWALLA
Suffix:
Gender:M
Credentials:MD,FACEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15,WEST GATE RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4554
Mailing Address - Country:US
Mailing Address - Phone:516-570-2234
Mailing Address - Fax:
Practice Address - Street 1:428 GRAHAM AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-1416
Practice Address - Country:US
Practice Address - Phone:718-383-3514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143513207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine