Provider Demographics
NPI:1659516417
Name:ALAM, MD SHAH (MD)
Entity Type:Individual
Prefix:
First Name:MD
Middle Name:SHAH
Last Name:ALAM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:708 SALISBURY PARK DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-5820
Mailing Address - Country:US
Mailing Address - Phone:516-385-1668
Mailing Address - Fax:347-380-9057
Practice Address - Street 1:17007 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-4546
Practice Address - Country:US
Practice Address - Phone:347-380-9050
Practice Address - Fax:347-380-9057
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2017-02-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY254156207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine