Healthcare Provider Details

I. General information

NPI: 1598758625
Provider Name (Legal Business Name): NABIL H. ABBASSI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1166 K ST
BRAWLEY CA
92227-2737
US

IV. Provider business mailing address

12 HENDRICK LANE #44E
TARRYTOWN NY
10591
US

V. Phone/Fax

Practice location:
  • Phone: 760-344-9951
  • Fax:
Mailing address:
  • Phone: 914-584-2689
  • Fax: 914-909-0679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number186231
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA50189
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: