Provider Demographics
NPI:1891236741
Name:TNAIMOU, ADIL (BOCPO & LPO)
Entity Type:Individual
Prefix:MR
First Name:ADIL
Middle Name:
Last Name:TNAIMOU
Suffix:
Gender:M
Credentials:BOCPO & LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 STONYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-2015
Mailing Address - Country:US
Mailing Address - Phone:215-269-3320
Mailing Address - Fax:215-269-3325
Practice Address - Street 1:377 STONYBROOK DR
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19055-2015
Practice Address - Country:US
Practice Address - Phone:215-269-3320
Practice Address - Fax:215-269-3325
Is Sole Proprietor?:No
Enumeration Date:2017-03-12
Last Update Date:2017-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOH000139222Z00000X
PAPO000216224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPO000216OtherPROSTHETIST LICENSE
PAOH000139OtherORTHOTIST LICENSE