Provider Demographics
NPI:1861735359
Name:DADUSH, ARIE AMNON (MD)
Entity type:Individual
Prefix:DR
First Name:ARIE
Middle Name:AMNON
Last Name:DADUSH
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 1:7 NOEL LN
Mailing Address - Street 2:
Mailing Address - City:JERICHO
Mailing Address - State:NY
Mailing Address - Zip Code:11753-1311
Mailing Address - Country:US
Mailing Address - Phone:646-351-4400
Mailing Address - Fax:
Practice Address - Street 1:680 W END AVE # 1AA
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6815
Practice Address - Country:US
Practice Address - Phone:917-965-2250
Practice Address - Fax:917-970-9114
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY298566207Q00000X, 207QS0010X
WAMD60762868207Q00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine