Provider Demographics
NPI:1003602475
Name:MOHAMED, ALA ELZUBIER
Entity type:Individual
Prefix:
First Name:ALA
Middle Name:ELZUBIER
Last Name:MOHAMED
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 OAKDALE AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-3141
Mailing Address - Country:US
Mailing Address - Phone:917-848-1920
Mailing Address - Fax:
Practice Address - Street 1:2300 OAKDALE AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-3141
Practice Address - Country:US
Practice Address - Phone:917-848-1920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty