Basic Information
| Provider Information | |||||||||
| NPI: | 1437682432 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | NAKHLA | ||||||||
| FirstName: | MARK | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1090 AMSTERDAM AVE STE 16F | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100251737 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2125234000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3600 FORBES AVE | ||||||||
| Address2: | FORBES TOWER - PLAZA SUITE 140 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133410 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126476340 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2017 | ||||||||
| LastUpdateDate: | 01/04/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/04/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | PA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2084P0800X | 309523 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.