Provider Demographics
NPI:1639207350
Name:ABDEL-WAHAB, NANCY H (MD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:H
Last Name:ABDEL-WAHAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 BRIDGE ST
Mailing Address - Street 2:APT 12K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-3807
Mailing Address - Country:US
Mailing Address - Phone:347-821-1639
Mailing Address - Fax:
Practice Address - Street 1:175 REMSEN ST
Practice Address - Street 2:4TH FLOOR, PREMIER HEALTH CARE
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4333
Practice Address - Country:US
Practice Address - Phone:718-306-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2485522084P0800X
CA1451752084P0800X
VA01012606092084P0800X
IL0361174422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036117442Medicaid
NY248552OtherNEW YORK STATE MEDICAL LICENSE