Provider Demographics
NPI:1033556600
Name:GORGE WASHINGTON UNIVERSITY
Entity Type:Organization
Organization Name:GORGE WASHINGTON UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGY RESIDENT PGY2
Authorized Official - Prefix:
Authorized Official - First Name:EALAF
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:ALRABIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-560-1499
Mailing Address - Street 1:4744 OAK ST
Mailing Address - Street 2:APT 940
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4744 OAK ST
Practice Address - Street 2:APT 940
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-2269
Practice Address - Country:US
Practice Address - Phone:312-560-1499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-22
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty