Healthcare Provider Details

I. General information

NPI: 1316608607
Provider Name (Legal Business Name): ABDEL NOFAL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 01/10/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2935 3RD AVE
BRONX NY
10455-2642
US

IV. Provider business mailing address

168 COOK AVE
YONKERS NY
10701-5265
US

V. Phone/Fax

Practice location:
  • Phone: 914-619-8913
  • Fax:
Mailing address:
  • Phone: 914-619-8913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: