Provider Demographics
NPI:1598963902
Name:NAKHLEH, NADER JOHN (DO)
Entity Type:Individual
Prefix:DR
First Name:NADER
Middle Name:JOHN
Last Name:NAKHLEH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 DAVIS AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4488
Mailing Address - Country:US
Mailing Address - Phone:732-776-4268
Mailing Address - Fax:732-776-3178
Practice Address - Street 1:19 DAVIS AVE FL 5
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4488
Practice Address - Country:US
Practice Address - Phone:732-776-4268
Practice Address - Fax:732-776-3178
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD0367452080P0214X
NJ25MB087814002080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0242594Medicaid