Provider Demographics
NPI:1144418799
Name:NAKHLA, SAMMY G (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMMY
Middle Name:G
Last Name:NAKHLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20 2ND ST
Mailing Address - Street 2:APT 2209
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3075
Mailing Address - Country:US
Mailing Address - Phone:917-686-7886
Mailing Address - Fax:
Practice Address - Street 1:325 MEETING HOUSE LN
Practice Address - Street 2:BLDG 2 SUITE 403
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-5087
Practice Address - Country:US
Practice Address - Phone:631-283-2100
Practice Address - Fax:631-283-5731
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2010-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY245824207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03024251Medicaid