Provider Demographics
NPI:1851062848
Name:ABBASI, HODA
Entity Type:Individual
Prefix:
First Name:HODA
Middle Name:
Last Name:ABBASI
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 1:50 ERNEST BARRETT PKWY STE 1000
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3344
Mailing Address - Country:US
Mailing Address - Phone:770-419-4049
Mailing Address - Fax:
Practice Address - Street 1:50 ERNEST BARRETT PKWY STE 1000
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3344
Practice Address - Country:US
Practice Address - Phone:770-419-4049
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH033292183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist