Healthcare Provider Details

I. General information

NPI: 1235128307
Provider Name (Legal Business Name): NASSER S AQEEL DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 ROUTE 22
BREWSTER NY
10509-1513
US

IV. Provider business mailing address

851 ROUTE 22
BREWSTER NY
10509-1513
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-4455
  • Fax:
Mailing address:
  • Phone: 845-279-4455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number048972-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: