Provider Demographics
NPI:1275721144
Name:NEBBARI, RAJAA I (MD)
Entity Type:Individual
Prefix:DR
First Name:RAJAA
Middle Name:
Last Name:NEBBARI
Suffix:I
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:P.O. BOX 957
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18501
Mailing Address - Country:US
Mailing Address - Phone:570-702-2098
Mailing Address - Fax:570-909-9096
Practice Address - Street 1:305 MULBERRY STREET
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18503
Practice Address - Country:US
Practice Address - Phone:570-702-2098
Practice Address - Fax:570-909-9096
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-04
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432633207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine