Provider Demographics
NPI:1366461923
Name:MOHAMMED, MAGDY IBRAHIM (MD)
Entity type:Individual
Prefix:DR
First Name:MAGDY
Middle Name:IBRAHIM
Last Name:MOHAMMED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MAGDY
Other - Middle Name:IBRAHIM
Other - Last Name:MOHAMMED
Other - Suffix:III
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2592 STEINWAY STREET
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103
Mailing Address - Country:US
Mailing Address - Phone:718-721-6100
Mailing Address - Fax:718-728-6744
Practice Address - Street 1:2592 STEINWAY ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3745
Practice Address - Country:US
Practice Address - Phone:718-721-6100
Practice Address - Fax:718-728-6744
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189433208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01369135Medicaid
NY1366461923Medicaid