Basic Information
| Provider Information | |||||||||
| NPI: | 1770753170 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DAGHER | ||||||||
| FirstName: | NABIL | ||||||||
| MiddleName: | NUHAD | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 403 E 34TH ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100164907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122633605 | ||||||||
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| Practice Location | |||||||||
| Address1: | 403 E 34TH ST FL 3 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100164907 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122633605 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/03/2008 | ||||||||
| LastUpdateDate: | 12/14/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204F00000X | D67378 | MD | N | Allopathic & Osteopathic Physicians | Transplant Surgery | 208600000X | 284705 | NY | N | Allopathic & Osteopathic Physicians | Surgery | 204F00000X | 284705 | NY | Y | Allopathic & Osteopathic Physicians | Transplant Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1801992631 | 05 | NY | MEDICAID | 330214 | 05 | NY | MEDICAID |