Individual
DR. WADIE BAHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
UNIVERSITY HOSPITAL, L5, STONY BROOK, NY 11794
(631) 444-2540
Mailing address
P.O. BOX 1559, STONY BROOK, NY 11790
(631) 444-2540
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
153826
NY
207RH0003X
Hematology & Oncology Physician
153826
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00785222
—
NY
01
—
44F88
EMPIRE BC.BS
NY
01
—
4621740
AETNA
NY
Enumeration date
07/11/2006
Last updated
04/27/2022
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