Provider Demographics
NPI:1184484420
Name:MOUSSA, HALA
Entity type:Individual
Prefix:
First Name:HALA
Middle Name:
Last Name:MOUSSA
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 1:1732 PEACHTREE CIR
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-4307
Mailing Address - Country:US
Mailing Address - Phone:484-373-1537
Mailing Address - Fax:
Practice Address - Street 1:1732 PEACHTREE CIR
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-4307
Practice Address - Country:US
Practice Address - Phone:484-373-1537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA31544374OtherDRIVER'S LICENSE