Individual provider · Type 1 NPI

Amenah Ibrahim, DO

Student in an Organized Health Care Education/Training Program · Port Jefferson, NY

NPI number 1043913981 Active

Practice location

75 N Country Rd
Port Jefferson, NY 11777-2190

Call (631) 686-2549 Map

Fax (631) 686-7651

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1043913981

Amenah Ibrahim, DO's National Provider Identifier is 1043913981, issued on Mar 22, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Port Jefferson, NY. The record was last updated on Mar 22, 2023.