Provider Demographics
NPI:1790717239
Name:ABULAIMOUN, BDAIR M III (MD)
Entity Type:Individual
Prefix:DR
First Name:BDAIR
Middle Name:M
Last Name:ABULAIMOUN
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:MANHASETT
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:845-348-2000
Mailing Address - Fax:
Practice Address - Street 1:300 COMUNITY DR
Practice Address - Street 2:SCHNEIDER CHILD.HOSPITAL -3 LEVITT
Practice Address - City:MANHASSETT
Practice Address - State:NY
Practice Address - Zip Code:11030-2377
Practice Address - Country:US
Practice Address - Phone:845-558-0200
Practice Address - Fax:516-562-4516
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA78125208000000X
NY2040072080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3164454Medicaid
MAJ18033OtherBLUE CROSS BLUE SHIELD
MAA22058Medicare PIN