Provider Demographics
NPI:1679739551
Name:BOTROS, AMGAD EMEAL (MD)
Entity Type:Individual
Prefix:
First Name:AMGAD
Middle Name:EMEAL
Last Name:BOTROS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:66 SUGAR MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-3229
Mailing Address - Country:US
Mailing Address - Phone:917-907-2819
Mailing Address - Fax:
Practice Address - Street 1:1946 BATH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4704
Practice Address - Country:US
Practice Address - Phone:718-360-0760
Practice Address - Fax:781-523-2482
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2024-05-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY249822207RC0000X
PAMD483608207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease