Provider Demographics
NPI:1841704517
Name:ALFRED, AMIN (CAMS)
Entity type:Individual
Prefix:MR
First Name:AMIN
Middle Name:
Last Name:ALFRED
Suffix:
Gender:M
Credentials:CAMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 JOHNSON AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-2690
Mailing Address - Country:US
Mailing Address - Phone:631-778-6657
Mailing Address - Fax:631-761-9475
Practice Address - Street 1:608 JOHNSON AVE STE 2
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-2690
Practice Address - Country:US
Practice Address - Phone:631-778-6657
Practice Address - Fax:631-761-9475
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist