Provider Demographics
NPI:1205849304
Name:RIMAWI, ROLA (MD)
Entity Type:Individual
Prefix:
First Name:ROLA
Middle Name:
Last Name:RIMAWI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 CHESTNUT ST
Mailing Address - Street 2:14TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:215-955-2420
Practice Address - Street 1:3900 FORD RD
Practice Address - Street 2:SUITE A
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-2039
Practice Address - Country:US
Practice Address - Phone:215-879-9346
Practice Address - Fax:215-879-9082
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229695207R00000X
PAMD432520207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0183768Medicaid
PA1022395540001Medicaid
PA141296PAGMedicare PIN
PA1022395540001Medicaid