Healthcare Provider Details

I. General information

NPI: 1073002986
Provider Name (Legal Business Name): OMAR CHEHAB M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2018
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date: 12/13/2018
Reactivation Date: 02/27/2019

III. Provider practice location address

161 FORT WASHINGTON AVENUE, NEW YORK
NEW YORK NY
10032
US

IV. Provider business mailing address

161 FORT WASHINGTON AVE
NEW YORK NY
10032-3729
US

V. Phone/Fax

Practice location:
  • Phone: 212-342-0444
  • Fax:
Mailing address:
  • Phone: 212-342-0444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number342380
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: