MEDICARE: DR. NABIL EL-GHOROURY PH.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	5983	OH
2	103T00000X	Psychologist	0810007882	VA

General Provider Information

NPI Number	:	1285665166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NABIL EL-GHOROURY PH.D

Provider Business Mailing Address
First Line	:	6412 BRANDON AVE # 304
Second Line	:
City	:	SPRINGFIELD
State	:	VA
Zip	:	22150-2513
Country	:	US
Telephone Number	:	202-753-4773
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 HUNTINGTON PARK DR
Second Line	:
City	:	ALEXANDRIA
State	:	VA
Zip	:	22303-2256
Country	:	US
Telephone Number	:	202-753-4773
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	10/24/2022

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