Provider Demographics
NPI:1972753861
Name:MEKAWY, NOURHAN (DDS)
Entity type:Individual
Prefix:
First Name:NOURHAN
Middle Name:
Last Name:MEKAWY
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 1:4 RED OAK CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-5516
Mailing Address - Country:US
Mailing Address - Phone:201-600-9756
Mailing Address - Fax:
Practice Address - Street 1:4 RED OAK CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-5516
Practice Address - Country:US
Practice Address - Phone:201-600-9756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-26
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH036831223G0001X
NY055172122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist