Abdullah Al-Mahayri, M.D.
Individual provider Active NPI Surgery Physician · Newark, NY
NPI 1720015480 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720015480
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Surgery Physician 208600000X
- License
- 185022 (NY)
- Practice address
- 111 Driving Park Ave
2ND Floor
Newark, NY 14513-1066 - Phone
- (315) 359-2670
- NPI assigned
- Jun 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 185022 | NY | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Anesthesia Associates of Rochester, P.C. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 185022 | NY | Yes |
Addresses
Primary practice location
111 Driving Park Ave
2ND Floor
Newark, NY 14513-1066
Mailing address
Driving Park Ave
Newark, NY 14513
Other providers in Newark, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.