Nour El Sham Mohamed Abdalla Omran

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

538 Broadhollow Road Suite 202
Achieve Beyond
Meville, NY 11747

Phone

(631) 385-7780

NPI assigned

Dec 14, 2016

Last updated

Dec 15, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1481673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1356885040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "538 BROADHOLLOW ROAD SUITE 202",
            "address_2": "ACHIEVE BEYOND",
            "city": "MEVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-385-7780",
            "fax_number": "631-385-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 BROADHOLLOW ROAD SUITE 202",
            "address_2": "ACHIEVE BEYOND",
            "city": "MEVILLE",
            "state": "NY",
            "postal_code": "11747",
            "telephone_number": "631-385-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMRAN",
        "first_name": "NOUR EL SHAM",
        "middle_name": "MOHAMED ABDALLA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-14",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.