Provider Demographics
NPI:1558949701
Name:EL FARRAH, ABEER M
Entity Type:Individual
Prefix:
First Name:ABEER
Middle Name:M
Last Name:EL FARRAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABEER
Other - Middle Name:M
Other - Last Name:EL-FARRAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1611 LOU GENE AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40216-5403
Mailing Address - Country:US
Mailing Address - Phone:502-744-0792
Mailing Address - Fax:
Practice Address - Street 1:1611 LOU GENE AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40216-5403
Practice Address - Country:US
Practice Address - Phone:502-744-0792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY86-2881612OtherIRS