Provider Demographics
NPI:1477637924
Name:WASEEM, AMIRA YASMIN (MD)
Entity Type:Individual
Prefix:
First Name:AMIRA
Middle Name:YASMIN
Last Name:WASEEM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMIRA
Other - Middle Name:YASMIN
Other - Last Name:ZAIDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 ELM LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-2406
Mailing Address - Country:US
Mailing Address - Phone:516-742-9663
Mailing Address - Fax:516-742-9663
Practice Address - Street 1:BUILDING 19 WEST ROAD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-222-0228
Practice Address - Fax:516-745-1519
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY220737208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics