Provider Demographics
NPI:1083355275
Name:ABOU LTAIF, SAHAR (RD)
Entity Type:Individual
Prefix:MS
First Name:SAHAR
Middle Name:
Last Name:ABOU LTAIF
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3755
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68103-0755
Mailing Address - Country:US
Mailing Address - Phone:402-354-5451
Mailing Address - Fax:
Practice Address - Street 1:8111 DODGE ST STE 220
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4117
Practice Address - Country:US
Practice Address - Phone:402-354-1320
Practice Address - Fax:402-354-5965
Is Sole Proprietor?:No
Enumeration Date:2022-04-05
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1626133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered