Healthcare Provider Details

I. General information

NPI: 1710088224
Provider Name (Legal Business Name): NADER E ATTIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 BARD AVE MEDICINE
STATEN ISLAND NY
10310-1664
US

IV. Provider business mailing address

450 W 33RD ST PBS 12TH FLOOR
NEW YORK NY
10001-2603
US

V. Phone/Fax

Practice location:
  • Phone: 712-818-2429
  • Fax: 718-818-3225
Mailing address:
  • Phone: 212-356-4474
  • Fax: 212-356-4608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number145869
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: