Provider Demographics
NPI:1003588690
Name:ELRIFAAI, AMNA H I
Entity Type:Individual
Prefix:MRS
First Name:AMNA
Middle Name:H
Last Name:ELRIFAAI
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19853 OUTER DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2066
Mailing Address - Country:US
Mailing Address - Phone:313-406-5056
Mailing Address - Fax:
Practice Address - Street 1:4560 PALMER ST
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126-2848
Practice Address - Country:US
Practice Address - Phone:313-740-9071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-01
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist