Provider Demographics
NPI:1881677748
Name:NAHAS, CHRISTIAN SHERIF (DO)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:SHERIF
Last Name:NAHAS
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 1:3 CALIFORNIA PL S
Mailing Address - Street 2:
Mailing Address - City:ISLAND PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11558-2216
Mailing Address - Country:US
Mailing Address - Phone:516-431-0698
Mailing Address - Fax:516-431-0767
Practice Address - Street 1:3 CALIFORNIA PL S
Practice Address - Street 2:
Practice Address - City:ISLAND PARK
Practice Address - State:NY
Practice Address - Zip Code:11558-2216
Practice Address - Country:US
Practice Address - Phone:516-431-0698
Practice Address - Fax:516-431-0767
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-23
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY184118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01356990Medicaid
NYF01525Medicare UPIN
NY01356990Medicaid