Provider Demographics
NPI:1164112447
Name:ABOU KHEIR, NADIA (MS)
Entity Type:Individual
Prefix:DR
First Name:NADIA
Middle Name:
Last Name:ABOU KHEIR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ATTENTION: RAJEH KALLOUL, 182-21 150TH AVE
Mailing Address - Street 2:MCT 111490
Mailing Address - City:SPRINGFIELDS GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ATTENTION: RAJEH KALLOUL, 182-21 150TH AVE
Practice Address - Street 2:MCT 111490
Practice Address - City:SPRINGFIELDS GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413
Practice Address - Country:US
Practice Address - Phone:718-553-8740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0001371223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics