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General NPI Number Information
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NPI Number | 1952285272
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Entity Type | Individual
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Provider Name | EMAN HABIB MATTA TAWADROS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 515 6TH ST
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City | BROOKLYN
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State | NY
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Zip | 11215-3608
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Country | US
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Telephone | 929-470-9524
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Fax |
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Provider Business Mailing Address
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Address Line | 1617 W 7TH ST
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City | BROOKLYN
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State | NY
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Zip | 11223-1342
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Country | US
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Telephone | 727-686-1668
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Fax | 727-686-1668
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 357045
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License Number State | NY
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