Doctor Name: | YEHIA MAZEN IBRAHIM NAGA |
NPI Number: | 1013290451 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 111 Brewster St Pawtucket, RI - 028604474 |
Business Phone Number: | 4017292221 |
Business Fax Number: | 4017292202 |
Mailing Address: | 1661 York Ave, Apt. 6g NEW YORK |
State: | NY |
Postal Code: | 101286551 |
Phone Number: | 9175387489 |
Fax Number: | |
NPI Enumeration Date: | 09/22/2011 |
NPI Last Update Date: | 05/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |