Provider Demographics
NPI:1205624533
Name:RADAIDEH, TALA OMAR
Entity type:Individual
Prefix:MRS
First Name:TALA
Middle Name:OMAR
Last Name:RADAIDEH
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:THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION
Mailing Address - Street 2:501 S. WASHINGTON AVENUE
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18505
Mailing Address - Country:US
Mailing Address - Phone:570-343-2383
Mailing Address - Fax:570-343-4800
Practice Address - Street 1:THE WRIGHT CENTER FOR GRADUATE MEDICAL EDUCATION
Practice Address - Street 2:501 S. WASHINGTON AVENUE
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18505
Practice Address - Country:US
Practice Address - Phone:570-343-2383
Practice Address - Fax:570-343-4800
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program