Provider Demographics
NPI:1306895891
Name:CHALHOUB, MICHEL NABIH (MD)
Entity type:Individual
Prefix:
First Name:MICHEL
Middle Name:NABIH
Last Name:CHALHOUB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 SEAVIEW AVENUE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10305
Mailing Address - Country:US
Mailing Address - Phone:718-980-5700
Mailing Address - Fax:718-980-5499
Practice Address - Street 1:501 SEAVIEW AVENUE
Practice Address - Street 2:SUITE 102
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305
Practice Address - Country:US
Practice Address - Phone:718-980-5700
Practice Address - Fax:718-980-5499
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY244456207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02889421Medicaid
7V2211OtherBLUE CROSS
P2665615OtherOXFORD
001633OtherHIP
0126950006OtherCIGNA
3092619OtherAETNA
2999461OtherGHI
4C4489OtherTOUCHSTONE
163361OtherHEALTHFIRST
7V2211OtherBLUE CROSS
NY02889421Medicaid