Provider Demographics
NPI:1790030153
Name:ALABBADY, AHMED MAGED (MD)
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:MAGED
Last Name:ALABBADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:AHMED
Other - Middle Name:MAGED HASAN
Other - Last Name:ALABBADY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:20 GRAND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-987-3906
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:12 LIBERTY SQUARE MALL
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2400
Practice Address - Country:US
Practice Address - Phone:845-942-1001
Practice Address - Fax:845-942-1431
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT201632207R00000X, 208600000X
VA0101269178207RI0011X
NY317265207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07242299Medicaid