Provider Demographics
NPI:1083764831
Name:ABDELAAL, HANY MOHAMED (DO)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:MOHAMED
Last Name:ABDELAAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-4117
Mailing Address - Country:US
Mailing Address - Phone:732-605-1615
Mailing Address - Fax:
Practice Address - Street 1:6323 7TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-4742
Practice Address - Country:US
Practice Address - Phone:718-921-7835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202721207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG28679Medicare UPIN