Provider Demographics
NPI:1467984591
Name:ADILEH, MOHAMMAD AMIN (MBBCH)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:AMIN
Last Name:ADILEH
Suffix:
Gender:M
Credentials:MBBCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 E 89TH ST
Mailing Address - Street 2:APT. 6A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7872
Mailing Address - Country:US
Mailing Address - Phone:646-599-6370
Mailing Address - Fax:
Practice Address - Street 1:504 E 89TH ST
Practice Address - Street 2:APT. 6A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-7872
Practice Address - Country:US
Practice Address - Phone:646-599-6370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP055002086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology