Provider Demographics
NPI:1336440130
Name:ABDALLAH, BILQEES B (FNP)
Entity type:Individual
Prefix:
First Name:BILQEES
Middle Name:B
Last Name:ABDALLAH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:BILQEES
Other - Middle Name:B
Other - Last Name:ABDUL-AZIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2732 ROODS CREEK RD # B-17
Mailing Address - Street 2:
Mailing Address - City:HANCOCK
Mailing Address - State:NY
Mailing Address - Zip Code:13783-1855
Mailing Address - Country:US
Mailing Address - Phone:607-621-8702
Mailing Address - Fax:607-467-2426
Practice Address - Street 1:2732 ROODS CREEK RD # B-17
Practice Address - Street 2:
Practice Address - City:HANCOCK
Practice Address - State:NY
Practice Address - Zip Code:13783-1855
Practice Address - Country:US
Practice Address - Phone:607-621-8702
Practice Address - Fax:607-467-2426
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF335928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400036682Medicare PIN