Provider Demographics
NPI:1144782194
Name:ELHUSSEINY, ABDELRAHMAN MAHMOUD (MD)
Entity Type:Individual
Prefix:
First Name:ABDELRAHMAN
Middle Name:MAHMOUD
Last Name:ELHUSSEINY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-3548
Mailing Address - Country:US
Mailing Address - Phone:312-843-9775
Mailing Address - Fax:
Practice Address - Street 1:1010 NW 11TH ST APT 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136-2225
Practice Address - Country:US
Practice Address - Phone:312-843-9775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program