Provider Demographics
NPI:1417649401
Name:ABDELRAHMAN, NORA NADINE (DDS)
Entity type:Individual
Prefix:DR
First Name:NORA
Middle Name:NADINE
Last Name:ABDELRAHMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 S RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5121
Mailing Address - Country:US
Mailing Address - Phone:845-309-3157
Mailing Address - Fax:
Practice Address - Street 1:138 PINE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-4947
Practice Address - Country:US
Practice Address - Phone:845-338-6900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064382122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist