Provider Demographics
NPI:1760463475
Name:ADEEB, NAGUI EMILE (MD)
Entity Type:Individual
Prefix:DR
First Name:NAGUI
Middle Name:EMILE
Last Name:ADEEB
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 1:11075 W CENTER STREET EXT
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:NY
Mailing Address - Zip Code:14103-9557
Mailing Address - Country:US
Mailing Address - Phone:585-798-0286
Mailing Address - Fax:585-798-4584
Practice Address - Street 1:11075 W CENTER STREET EXT
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:NY
Practice Address - Zip Code:14103-9557
Practice Address - Country:US
Practice Address - Phone:585-798-0286
Practice Address - Fax:585-798-4584
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114547208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400013125Medicare PIN
NYB36029Medicare UPIN