Provider Demographics
NPI:1063511970
Name:ABBOUD, AIMAN MICHAEL (MD DO)
Entity Type:Individual
Prefix:DR
First Name:AIMAN
Middle Name:MICHAEL
Last Name:ABBOUD
Suffix:
Gender:M
Credentials:MD DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1009 BRIGHTON BEACH AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5606
Mailing Address - Country:US
Mailing Address - Phone:718-743-3121
Mailing Address - Fax:718-743-3183
Practice Address - Street 1:1009 BRIGHTON BEACH AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5606
Practice Address - Country:US
Practice Address - Phone:718-743-3121
Practice Address - Fax:718-743-3183
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232699207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02634128Medicaid
NY02634128Medicaid