Provider Demographics
NPI:1568570703
Name:IBRAHIM HARRIS, RASHA A (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:RASHA
Middle Name:A
Last Name:IBRAHIM HARRIS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9196
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-2196
Mailing Address - Country:US
Mailing Address - Phone:340-776-7342
Mailing Address - Fax:340-776-7349
Practice Address - Street 1:5302 YACHT HAVEN GRANDE
Practice Address - Street 2:SUTIE S-100
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5004
Practice Address - Country:US
Practice Address - Phone:340-776-7342
Practice Address - Fax:340-776-7349
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI81225100000X
VA2305202655225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VI0021347Medicare ID - Type Unspecified