Provider Demographics
NPI:1104381094
Name:ABDELRASOUL, AHLAM
Entity Type:Individual
Prefix:
First Name:AHLAM
Middle Name:
Last Name:ABDELRASOUL
Suffix:
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 1:7954 W LINCOLN ST NE
Mailing Address - Street 2:
Mailing Address - City:MASURY
Mailing Address - State:OH
Mailing Address - Zip Code:44438-9780
Mailing Address - Country:US
Mailing Address - Phone:330-509-1678
Mailing Address - Fax:
Practice Address - Street 1:7954 W LINCOLN ST NE
Practice Address - Street 2:
Practice Address - City:MASURY
Practice Address - State:OH
Practice Address - Zip Code:44438-9780
Practice Address - Country:US
Practice Address - Phone:330-509-1678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program