Healthcare Provider Details

I. General information

NPI: 1164714820
Provider Name (Legal Business Name): ABEER DABBAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 OCEAN PARKWAY
BROOKLYN NY
11235
US

IV. Provider business mailing address

672 DOGWOOD AVE #154
FRANKLIN SQUARE NY
11010
US

V. Phone/Fax

Practice location:
  • Phone: 718-616-3257
  • Fax:
Mailing address:
  • Phone: 516-451-5998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number012530
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: