Hamid Jack Moallem, M.D.

Primary specialty

Pediatric Allergy/Immunology PhysicianTaxonomy code 2080P0201X

License

183019-1 Issued in NY

Practice address

450 Clarkson Ave
B4-333
Brooklyn, NY 11203-2056

Phone

(718) 270-4714

Fax

(718) 270-1985

NPI assigned

Dec 8, 2005

Last updated

Feb 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Physicians of Brooklyn, Inc.

  dba Downstate Health Physicians

  • Pediatrics Physician
  • Brooklyn, NY
  • NPI 1649227190

  Pediatric Allergy/Immunology

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361923200000",
    "number": "1013992494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-8867",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "B4-333",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-4714",
            "fax_number": "718-270-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOALLEM",
        "first_name": "HAMID JACK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-08",
        "last_updated": "2013-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0201X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Allergy/Immunology",
            "state": "NY",
            "license": "183019-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01422884",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Malek Mneimne, PHD
• Mo KS ABA LLC
• Miney Mo
• Qingxiang Mo
• Yvonne Mo
• Dina Moazamian, MD
• Sadia Mobeen, D.O
• Nicole Kaenie Moberly
• Mobile Cardio Vascular Inc.,
• Mobile Diagnostic Testing Inc

• Pediatric Allergy/Immunology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatric Allergy/Immunology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.