Provider Demographics
NPI:1639930811
Name:MOHAMED, EGLAL ELTIGANI (CASE MANAGER)
Entity Type:Individual
Prefix:MRS
First Name:EGLAL
Middle Name:ELTIGANI
Last Name:MOHAMED
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:MRS
Other - First Name:EGLAL
Other - Middle Name:ELTIGANI
Other - Last Name:MOHAMED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CASE MANAGER
Mailing Address - Street 1:15 LENOX ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2665
Mailing Address - Country:US
Mailing Address - Phone:413-737-2601
Mailing Address - Fax:413-737-0323
Practice Address - Street 1:15 LENOX ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2665
Practice Address - Country:US
Practice Address - Phone:413-737-2601
Practice Address - Fax:413-737-0323
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAS54524775171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator