Healthcare Provider Details

I. General information

NPI: 1235802976
Provider Name (Legal Business Name): MARIAM M CHEAIB NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E 34TH ST
NEW YORK NY
10016-4744
US

IV. Provider business mailing address

160 E 34TH ST
NEW YORK NY
10016-4744
US

V. Phone/Fax

Practice location:
  • Phone: 212-731-6465
  • Fax:
Mailing address:
  • Phone: 929-819-2878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF35564
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704314169
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: