Healthcare Provider Details

I. General information

NPI: 1285357160
Provider Name (Legal Business Name): NAGHAM DAOUD PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 09/26/2022
Certification Date: 09/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 DARTMOUTH LOOP FL 2
STATEN ISLAND NY
10306-4801
US

IV. Provider business mailing address

26 DARTMOUTH LOOP FL 2
STATEN ISLAND NY
10306-4801
US

V. Phone/Fax

Practice location:
  • Phone: 347-481-2149
  • Fax:
Mailing address:
  • Phone: 347-481-2149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number029026
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: