Provider Demographics
NPI:1710522230
Name:ABDULLAHI, ABDULLAHI HASSAN
Entity Type:Individual
Prefix:
First Name:ABDULLAHI
Middle Name:HASSAN
Last Name:ABDULLAHI
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 1:5680 W 140TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-1988
Mailing Address - Country:US
Mailing Address - Phone:507-213-4008
Mailing Address - Fax:
Practice Address - Street 1:5680 W 140TH ST
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-1988
Practice Address - Country:US
Practice Address - Phone:507-213-4008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-07
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide