Provider Demographics
NPI:1376422063
Name:ABDUL-RAHIM, KIARAH
Entity type:Individual
Prefix:
First Name:KIARAH
Middle Name:
Last Name:ABDUL-RAHIM
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 1:104 JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19012-2209
Mailing Address - Country:US
Mailing Address - Phone:215-668-5295
Mailing Address - Fax:
Practice Address - Street 1:1417 OLD YORK RD
Practice Address - Street 2:SUITE 207B
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-2209
Practice Address - Country:US
Practice Address - Phone:215-668-5295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
PACT177665174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies