Healthcare Provider Details

I. General information

NPI: 1760480404
Provider Name (Legal Business Name): SOUAD BEKHEIT SAAD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 SEAVIEW AVE STE 300
STATEN ISLAND NY
10305-3436
US

IV. Provider business mailing address

501 SEAVIEW AVE STE 300
STATEN ISLAND NY
10305-3436
US

V. Phone/Fax

Practice location:
  • Phone: 718-663-7000
  • Fax: 718-663-7090
Mailing address:
  • Phone: 718-663-7000
  • Fax: 718-663-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number169791
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: