Provider Demographics
NPI:1609374172
Name:RABADI, HAITHAM S (EMT)
Entity Type:Individual
Prefix:MR
First Name:HAITHAM
Middle Name:S
Last Name:RABADI
Suffix:
Gender:M
Credentials:EMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:923 SAW MILL RIVER ROAD
Mailing Address - Street 2:283
Mailing Address - City:ARDSLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10502
Mailing Address - Country:US
Mailing Address - Phone:914-591-5404
Mailing Address - Fax:
Practice Address - Street 1:140 HUNTLEY DR
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-1223
Practice Address - Country:US
Practice Address - Phone:914-591-5404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-30
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYW202310C344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY570770814OtherNYS DMV
NY370954OtherNY STATE DEPARTMENT OF HEALTH EMT - B