Mudar Dalloul, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

227244-1 Issued in NY

Practice address

450 Clarkson Ave
Suite G
Brooklyn, NY 11203-2056

Phone

(718) 363-2908

Fax

(718) 270-4122

NPI assigned

Sep 22, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H3359

Interoperability endpoints

• Direct secure messaging: mudardalloul@sunydmc.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• University Hospital of Brooklyn Suny Downstate Health Sciences Univers

  • Family Medicine Physician
  • Brooklyn, NY
  • NPI 1396318986

  Obstetrics & Gynecology

  Medicare reassignment NPD
• University Hospital of Brooklyn Suny Downstate Health Sciences Univers

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Brooklyn, NY
  • NPI 1528027414
  NPD
• University Hospital of Brooklyn Suny Downstate Health Sciences Univers

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1740853340
  NPD
• State of New York Comptrollers Office

  • Developmental Disabilities Clinic/Center
  • Brewster, NY
  • NPI 1043335284
  NPD (past)
• Suny Downstate Medical Center

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1699704155
  NPD (past)
• University Hospital of Brooklyn Suny Downstate Health Sciences Univers

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1639179328
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053307348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "BOX 1262",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-270-8867",
            "fax_number": "718-270-1794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLARKSON AVE",
            "address_2": "SUITE G",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032056",
            "telephone_number": "718-363-2908",
            "fax_number": "718-270-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLOUL",
        "first_name": "MUDAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "227244-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02377071",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manisha Dallakoti
• Katherine Dallalio
• Lambros Dallas, OTR/L
• Lindsay Dallemand
• Nina Dallenbach, PSYM
• Jonathan Samuel Dally
• Dolcine Dalmacy, M.D.
• Kesler Dalmacy
• Margarette Dalmacy
• Betty Consuelo Dalmasi Gomez, DDS

• Obstetrics & Gynecology Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Obstetrics & Gynecology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.