Provider Demographics
NPI:1033617733
Name:ABDELLA, OMNIA M (RN)
Entity Type:Individual
Prefix:
First Name:OMNIA
Middle Name:M
Last Name:ABDELLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BAY 38TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4453
Mailing Address - Country:US
Mailing Address - Phone:718-501-9581
Mailing Address - Fax:
Practice Address - Street 1:46 BAY 38TH ST APT 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4453
Practice Address - Country:US
Practice Address - Phone:718-501-9581
Practice Address - Fax:718-501-9581
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY741573163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool