Provider Demographics
NPI:1043691157
Name:SALAMEH, NIDAL ZAHI
Entity Type:Individual
Prefix:
First Name:NIDAL
Middle Name:ZAHI
Last Name:SALAMEH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 WEST ST APT 6E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6437
Mailing Address - Country:US
Mailing Address - Phone:703-626-6975
Mailing Address - Fax:
Practice Address - Street 1:2127 1ST AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3339
Practice Address - Country:US
Practice Address - Phone:212-426-8202
Practice Address - Fax:212-426-6802
Is Sole Proprietor?:No
Enumeration Date:2015-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY058508-1122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist