Provider Demographics
NPI:1992373443
Name:ABDELMOTTALEB, WAEL ALI MANSOUR (MD)
Entity Type:Individual
Prefix:DR
First Name:WAEL
Middle Name:ALI MANSOUR
Last Name:ABDELMOTTALEB
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 1:1901 FIRST AVENUE, METROPOLITAN HOSPITAL CENTER
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029
Mailing Address - Country:US
Mailing Address - Phone:212-423-0771
Mailing Address - Fax:212-423-8099
Practice Address - Street 1:1901 FIRST AVENUE, METROPOLITAN HOSPITAL CENTER
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-423-6771
Practice Address - Fax:212-423-8099
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2023-01-31
Deactivation Date:2022-12-01
Deactivation Code:
Reactivation Date:2023-01-31
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program