1982538237 NPI number — MISS NADA DECRUSE WAANBAH M.D.

Table of content: MISS NADA DECRUSE WAANBAH M.D. (NPI 1982538237)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982538237 NPI number — MISS NADA DECRUSE WAANBAH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WAANBAH
Provider First Name:
NADA
Provider Middle Name:
DECRUSE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1982538237
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/11/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WOODHULL / NYC HEALTH HOSPITALS
Provider Second Line Business Mailing Address:
760 BROADWAY, PEDIATRIC ADMINISTRATION / 6TH FLOOR
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-963-8779
Provider Business Mailing Address Fax Number:
718-963-7957

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
WOODHULL / NYC HEALTH HOSPITALS
Provider Second Line Business Practice Location Address:
760 BROADWAY, PEDIATRIC ADMINISTRATION / 6TH FLOOR
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-963-8779
Provider Business Practice Location Address Fax Number:
718-963-7957
Provider Enumeration Date:
06/11/2026

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 , 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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