Healthcare Provider Details

I. General information

NPI: 1972731776
Provider Name (Legal Business Name): OSCAR BOUTROS LAHOUD M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2009
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2236 NOSTRAND AVE
BROOKLYN NY
11210-3037
US

IV. Provider business mailing address

2236 NOSTRAND AVE
BROOKLYN NY
11210-3037
US

V. Phone/Fax

Practice location:
  • Phone: 516-559-1523
  • Fax: 516-515-5959
Mailing address:
  • Phone: 516-559-1523
  • Fax: 516-515-5959

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number265765
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number265765
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number265765
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: