Provider Demographics
NPI:1770638041
Name:NEJMEH-KHOURY, SANA YOUSSEF (MD)
Entity Type:Individual
Prefix:DR
First Name:SANA
Middle Name:YOUSSEF
Last Name:NEJMEH-KHOURY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:670 92ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228-3632
Mailing Address - Country:US
Mailing Address - Phone:718-833-7466
Mailing Address - Fax:
Practice Address - Street 1:47 78TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-2911
Practice Address - Country:US
Practice Address - Phone:718-745-2359
Practice Address - Fax:718-745-2378
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225782-1174400000X
NY225782208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7822679OtherAETNA NON-HMO
NY02712178Medicaid
NY5C4328OtherHEALTH NET
NYNY225782-1Other1199SEIU
NY3818374OtherAETNA HMO