Provider Demographics
NPI:1235493008
Name:AL-RAMAHI, KEFAH RAED A (MD)
Entity Type:Individual
Prefix:
First Name:KEFAH
Middle Name:RAED A
Last Name:AL-RAMAHI
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 1:2 NORTHWESTERN DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-6401
Mailing Address - Country:US
Mailing Address - Phone:860-696-4690
Mailing Address - Fax:
Practice Address - Street 1:230 MAPLE ST STE 1
Practice Address - Street 2:
Practice Address - City:HOLYOKE
Practice Address - State:MA
Practice Address - Zip Code:01040-5140
Practice Address - Country:US
Practice Address - Phone:413-420-1733
Practice Address - Fax:413-536-9947
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA261977207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAS400251109Medicare PIN