Provider Demographics
NPI:1861249468
Name:FOULY, NORA
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:
Last Name:FOULY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORA
Other - Middle Name:
Other - Last Name:ABDELHAFIZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:803 W LAYTON AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53221-2426
Mailing Address - Country:US
Mailing Address - Phone:414-939-4411
Mailing Address - Fax:414-939-4466
Practice Address - Street 1:803 W LAYTON AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53221-2426
Practice Address - Country:US
Practice Address - Phone:414-939-4411
Practice Address - Fax:414-939-4466
Is Sole Proprietor?:No
Enumeration Date:2024-05-01
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7001259-16124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist