MEDICARE: DR. NASHAT S. ATALLA M.D.

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	D0062594	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1866233	OTHER	NY	GHI

General Provider Information

NPI Number	:	1245208065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NASHAT S. ATALLA M.D.

Provider Business Mailing Address
First Line	:	82 HOLLAND STREET
Second Line	:	ALJHC
City	:	ROCHESTER
State	:	NY
Zip	:	14605
Country	:	US
Telephone Number	:	585-423-5800
Fax Number	:	585-423-2890

Provider Business Practice Location Address
First Line	:	82 HOLLAND STREET
Second Line	:	ALJHC
City	:	ROCHESTER
State	:	NY
Zip	:	14605
Country	:	US
Telephone Number	:	585-423-5800
Fax Number	:	585-423-2890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	08/13/2015

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