Provider Demographics
NPI:1497528038
Name:AL-QADAN, NAHEEL
Entity Type:Individual
Prefix:
First Name:NAHEEL
Middle Name:
Last Name:AL-QADAN
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 1:86 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:OH
Mailing Address - Zip Code:44212-1528
Mailing Address - Country:US
Mailing Address - Phone:216-635-8696
Mailing Address - Fax:
Practice Address - Street 1:870 N COURT ST
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-1719
Practice Address - Country:US
Practice Address - Phone:330-723-8873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03443499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist