Provider Demographics
NPI:1548274905
Name:NADER, NADER DJALAL (MD, PHD)
Entity type:Individual
Prefix:PROF
First Name:NADER
Middle Name:DJALAL
Last Name:NADER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 BAILEY AVE
Mailing Address - Street 2:VAMC, RM 203 C
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14215-1129
Mailing Address - Country:US
Mailing Address - Phone:716-862-8707
Mailing Address - Fax:716-862-8709
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:VAMC, RM 203 C
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-862-8707
Practice Address - Fax:716-862-8709
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY208077207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Not Answered207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine