Provider Demographics
NPI:1285665166
Name:EL-GHOROURY, NABIL (PHD)
Entity Type:Individual
Prefix:DR
First Name:NABIL
Middle Name:
Last Name:EL-GHOROURY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6412 BRANDON AVE # 304
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150-2513
Mailing Address - Country:US
Mailing Address - Phone:202-753-4773
Mailing Address - Fax:
Practice Address - Street 1:2425 HUNTINGTON PARK DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22303-2256
Practice Address - Country:US
Practice Address - Phone:202-753-4773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5983103T00000X
VA0810007882103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2455516Medicaid
OHELCP78831Medicare ID - Type Unspecified
OHQ02917Medicare UPIN