Provider Demographics
NPI:1649681743
Name:NAHAS, RAWAN (MD)
Entity type:Individual
Prefix:
First Name:RAWAN
Middle Name:
Last Name:NAHAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2450 W HUNTING PARK AVE
Mailing Address - Street 2:FL 3
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1302
Mailing Address - Country:US
Mailing Address - Phone:914-606-1524
Mailing Address - Fax:
Practice Address - Street 1:500 OLD YORK ROAD
Practice Address - Street 2:SUITE 250
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-884-5060
Practice Address - Fax:215-572-1575
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461959208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty