Provider Demographics
NPI:1609564350
Name:ELRAYAH, IHAB SIDAHMED
Entity Type:Individual
Prefix:
First Name:IHAB
Middle Name:SIDAHMED
Last Name:ELRAYAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1776 W CARLA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-8203
Mailing Address - Country:US
Mailing Address - Phone:480-410-8496
Mailing Address - Fax:
Practice Address - Street 1:1776 W CARLA VISTA DR
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-8203
Practice Address - Country:US
Practice Address - Phone:480-410-8496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor