Provider Demographics
NPI:1952549800
Name:BAGHDADI, SALIM (MD)
Entity Type:Individual
Prefix:DR
First Name:SALIM
Middle Name:
Last Name:BAGHDADI
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 1:12510 QUEENS BLVD
Mailing Address - Street 2:SUITE 2701
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1519
Mailing Address - Country:US
Mailing Address - Phone:718-261-0444
Mailing Address - Fax:718-261-0940
Practice Address - Street 1:12510 QUEENS BLVD
Practice Address - Street 2:SUITE 2701
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1519
Practice Address - Country:US
Practice Address - Phone:718-261-0444
Practice Address - Fax:718-261-0940
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253133174400000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY253133OtherLICENSE