Provider Demographics
NPI:1710483987
Name:ABDI, OMAR (TRANSPORTATION)
Entity Type:Individual
Prefix:MR
First Name:OMAR
Middle Name:
Last Name:ABDI
Suffix:
Gender:M
Credentials:TRANSPORTATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-0326
Mailing Address - Country:US
Mailing Address - Phone:802-829-9383
Mailing Address - Fax:
Practice Address - Street 1:1792 KENMORE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14216-1025
Practice Address - Country:US
Practice Address - Phone:802-829-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04941755Medicaid