Provider Demographics
NPI:1467029496
Name:GHALLAB, MUHAMMAD ELSAYED (MD)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD
Middle Name:ELSAYED
Last Name:GHALLAB
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 1:7840 164TH ST APT 6D
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:929-582-9048
Mailing Address - Fax:718-883-6197
Practice Address - Street 1:82-68 164TH STREET, N BUILDING, 7TH FL, RM N-705
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432
Practice Address - Country:US
Practice Address - Phone:718-883-3000
Practice Address - Fax:718-883-6197
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program