Provider Demographics
NPI:1235611237
Name:ABDELWAHED, NANCY ALAAELDIN ALY
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ALAAELDIN ALY
Last Name:ABDELWAHED
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 CUMBERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1733
Mailing Address - Country:US
Mailing Address - Phone:518-335-1241
Mailing Address - Fax:
Practice Address - Street 1:64 CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1733
Practice Address - Country:US
Practice Address - Phone:518-335-1241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist