MEDICARE: DR. NABIL RACHED MEGALLY M.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	174400000X	Specialist	130061	NY

General Provider Information

NPI Number	:	1871699892
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NABIL RACHED MEGALLY M.D.

Provider Business Mailing Address
First Line	:	3060 CRESCENT ST
Second Line	:	SUITE A
City	:	ASTORIA
State	:	NY
Zip	:	11102-3239
Country	:	US
Telephone Number	:	718-204-6444
Fax Number	:	718-267-0700

Provider Business Practice Location Address
First Line	:	3060 CRESCENT ST
Second Line	:	SUITE A
City	:	ASTORIA
State	:	NY
Zip	:	11102-3239
Country	:	US
Telephone Number	:	718-204-6444
Fax Number	:	718-267-0700

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

Provider Enumeration Date	:	09/16/2006
Last Update Date	:	07/09/2007

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