Provider Demographics
NPI:1720015480
Name:AL-MAHAYRI, ABDULLAH (MD)
Entity Type:Individual
Prefix:
First Name:ABDULLAH
Middle Name:
Last Name:AL-MAHAYRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DRIVING PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NY
Mailing Address - Zip Code:14513
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 DRIVING PARK AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1066
Practice Address - Country:US
Practice Address - Phone:315-359-2670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY185022208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery