Healthcare Provider Details

I. General information

NPI: 1790336626
Provider Name (Legal Business Name): RAHAF REZEK SALIB FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

257 CENTER ST
WILLISTON PARK NY
11596-1021
US

IV. Provider business mailing address

257 CENTER ST
WILLISTON PARK NY
11596-1021
US

V. Phone/Fax

Practice location:
  • Phone: 718-401-1510
  • Fax:
Mailing address:
  • Phone: 218-693-1435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360003
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: