Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | 248628 | NY |
Y | 2080P0208X | Pediatric Infectious Diseases | 25MB09174000 | NJ |
NPI | 1598089195 |
---|---|
Provider Name | Dr. Sabah Kalyoussef |
First Address | New Brunswick, NJ 08901-1766 |
Second Address | New Brunswick, NJ 08901-1766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2010 |
Last Update Date | 12/12/2016 |