MEDICARE: ADIB ALHADDAD, MD, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	250517	NY
2	207RN0300X	Nephrology Physician	250517	NY

General Provider Information

NPI Number	:	1114357050
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADIB ALHADDAD, MD, PLLC

Provider Business Mailing Address
First Line	:	82 77TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2919
Country	:	US
Telephone Number	:	917-470-4378
Fax Number	:

Provider Business Practice Location Address
First Line	:	466 BAY RIDGE AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11220-5906
Country	:	US
Telephone Number	:	718-491-2003
Fax Number	:	718-491-2007

Authorized Official
Title or Position	:	MD
Name	:	DR. ADIB ALHADDAD
Credential	:
Telephone Number	:	917-470-4378

Provider Enumeration Date	:	11/13/2013
Last Update Date	:	04/03/2023

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