Provider Demographics
NPI:1841797057
Name:SAEYELDIN, AYMAN A (MD)
Entity Type:Individual
Prefix:
First Name:AYMAN
Middle Name:A
Last Name:SAEYELDIN
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 1:146 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1327
Mailing Address - Country:US
Mailing Address - Phone:475-209-0016
Mailing Address - Fax:
Practice Address - Street 1:205 SOUTH FRONT STREET, BRADY HALL SUITE 3C
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104
Practice Address - Country:US
Practice Address - Phone:717-231-8506
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT06-0646844Medicaid