Provider Demographics
NPI:1356570311
Name:ABOSHIHATA, HEBA (MD)
Entity type:Individual
Prefix:
First Name:HEBA
Middle Name:
Last Name:ABOSHIHATA
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 1:259 FIRST STREET
Mailing Address - Street 2:ROOM 291
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501
Mailing Address - Country:US
Mailing Address - Phone:516-663-8963
Mailing Address - Fax:516-663-8964
Practice Address - Street 1:259 FIRST STREET
Practice Address - Street 2:ROOM 291
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501
Practice Address - Country:US
Practice Address - Phone:516-663-8963
Practice Address - Fax:516-663-8964
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY252943207R00000X
NY2529431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine