Provider Demographics
NPI:1164991139
Name:ALKHUZAMI, BAYAN
Entity Type:Individual
Prefix:
First Name:BAYAN
Middle Name:
Last Name:ALKHUZAMI
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 1:120 SCHINDLER CT APT 439
Mailing Address - Street 2:
Mailing Address - City:EAST RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07073-2206
Mailing Address - Country:US
Mailing Address - Phone:718-668-4454
Mailing Address - Fax:
Practice Address - Street 1:120 SCHINDLER CT APT 439
Practice Address - Street 2:
Practice Address - City:EAST RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07073-2206
Practice Address - Country:US
Practice Address - Phone:718-668-4454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7107321163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse