Provider Demographics
NPI:1689045031
Name:ABUD, NAWAL
Entity Type:Individual
Prefix:
First Name:NAWAL
Middle Name:
Last Name:ABUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 COMMERCE WAY
Mailing Address - Street 2:SUITE 120
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-8200
Mailing Address - Country:US
Mailing Address - Phone:603-427-8066
Mailing Address - Fax:603-501-0495
Practice Address - Street 1:300 TRADECENTER
Practice Address - Street 2:SUITE 1650
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-1883
Practice Address - Country:US
Practice Address - Phone:781-935-2655
Practice Address - Fax:781-935-9097
Is Sole Proprietor?:No
Enumeration Date:2015-10-12
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist