Provider Demographics
NPI:1609642206
Name:ALSOMALI, SIHAM FOUZI A
Entity Type:Individual
Prefix:
First Name:SIHAM
Middle Name:FOUZI A
Last Name:ALSOMALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SIHAM FOUZI A
Other - Middle Name:
Other - Last Name:ALSOMALI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5120 CHESTER AVE APT C
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19143-4381
Mailing Address - Country:US
Mailing Address - Phone:267-271-5722
Mailing Address - Fax:
Practice Address - Street 1:5120 CHESTER AVE APT C
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-4381
Practice Address - Country:US
Practice Address - Phone:267-271-5722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-27
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN751361163WE0003X
NY432895363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WE0003XNursing Service ProvidersRegistered NurseEmergency