Provider Demographics
NPI:1417287400
Name:ELDEEB, ELSAYED HAMMAD (MD)
Entity Type:Individual
Prefix:
First Name:ELSAYED
Middle Name:HAMMAD
Last Name:ELDEEB
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 1:1946 BATH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4704
Mailing Address - Country:US
Mailing Address - Phone:718-996-7460
Mailing Address - Fax:718-996-7461
Practice Address - Street 1:1946 BATH AVE
Practice Address - Street 2:# 1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4704
Practice Address - Country:US
Practice Address - Phone:347-866-8103
Practice Address - Fax:718-871-8950
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-13
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY262324207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine