Kazzaz, Nelly Yacoub

Kazzaz, Nelly Yacoub is an individual health care provider with primary practice located at 4820 W Taft Rd Suite 201, Liverpool NY 13088-2800. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Kazzaz, Nelly Yacoub can be contacted via phone (315) 234-0906.

Contact Information

Primary practice address
4820 W Taft Rd Suite 201 Liverpool NY 13088-2800
Phone: (315) 234-0906
Fax: (315) 234-4416
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 254476 New York

Profile Details

NPI number 1760470900
LBN Legal business name Kazzaz, Nelly Yacoub
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Oct 14th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760470900 NPPES
Illinois Other 208409001 MEDICARE PTAN

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