Healthcare Provider Details

I. General information

NPI: 1346219466
Provider Name (Legal Business Name): NASHAT Y GABRAIL MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 06/14/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4875 HIGBEE AVE NW
CANTON OH
44718-2566
US

IV. Provider business mailing address

4875 HIGBEE AVE NW
CANTON OH
44718-2566
US

V. Phone/Fax

Practice location:
  • Phone: 330-492-3345
  • Fax: 330-492-0462
Mailing address:
  • Phone: 330-492-3345
  • Fax: 330-491-9758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number35-06-0196
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number35060196G
License Number StateOH

VIII. Authorized Official

Name: DR. NASHAT Y GABRAIL
Title or Position: PRES/OWNER
Credential: MD
Phone: 330-492-3345