1467029496 NPI number — DR. MUHAMMAD ELSAYED GHALLAB M.D.

Table of content: DR. MUHAMMAD ELSAYED GHALLAB M.D. (NPI 1467029496)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467029496 NPI number — DR. MUHAMMAD ELSAYED GHALLAB M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GHALLAB
Provider First Name:
MUHAMMAD
Provider Middle Name:
ELSAYED
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467029496
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7840 164TH ST APT 6D
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRESH MEADOWS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
929-582-9048
Provider Business Mailing Address Fax Number:
718-883-6197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
82-68 164TH STREET, N BUILDING, 7TH FL, RM N-705
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11432
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-883-3000
Provider Business Practice Location Address Fax Number:
718-883-6197
Provider Enumeration Date:
06/08/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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