Provider Demographics
NPI:1083335343
Name:ABDALLA, ESSAM I (CERTIFIED PHLEBOTOMI)
Entity Type:Individual
Prefix:
First Name:ESSAM
Middle Name:
Last Name:ABDALLA
Suffix:I
Gender:M
Credentials:CERTIFIED PHLEBOTOMI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:CHEPACHET
Mailing Address - State:RI
Mailing Address - Zip Code:02814-1622
Mailing Address - Country:US
Mailing Address - Phone:401-556-0499
Mailing Address - Fax:
Practice Address - Street 1:67 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:CHEPACHET
Practice Address - State:RI
Practice Address - Zip Code:02814-1622
Practice Address - Country:US
Practice Address - Phone:401-556-0499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy