Provider Demographics
NPI:1326414152
Name:NAHAB, BASHAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BASHAR
Middle Name:
Last Name:NAHAB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 E 117TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-4777
Mailing Address - Country:US
Mailing Address - Phone:718-579-5874
Mailing Address - Fax:718-579-4836
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-245-3613
Practice Address - Fax:513-585-5511
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-16
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
OH35.1422532085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No282N00000XHospitalsGeneral Acute Care Hospital