Provider Demographics
NPI:1821353244
Name:GALAL EL-DIN, AMIR MOHAMMAD (LMSW)
Entity Type:Individual
Prefix:MR
First Name:AMIR
Middle Name:MOHAMMAD
Last Name:GALAL EL-DIN
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:DR
Other - First Name:AMIR
Other - Middle Name:MOHAMMAD
Other - Last Name:GALAL EL-DIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DHSC
Mailing Address - Street 1:25 CLIFTON AVE APT D1013
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-1842
Mailing Address - Country:US
Mailing Address - Phone:973-482-1025
Mailing Address - Fax:973-482-1025
Practice Address - Street 1:25 CLIFTON AVE APT D1013
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-1842
Practice Address - Country:US
Practice Address - Phone:973-482-1025
Practice Address - Fax:973-482-1025
Is Sole Proprietor?:No
Enumeration Date:2012-07-11
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070233-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker