Provider Demographics
NPI:1295096295
Name:IBRAHIM, NAEMA
Entity type:Individual
Prefix:MS
First Name:NAEMA
Middle Name:
Last Name:IBRAHIM
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 1:3993 PRINCE GEORGE LN
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-8947
Mailing Address - Country:US
Mailing Address - Phone:202-651-0819
Mailing Address - Fax:
Practice Address - Street 1:3993 PRINCE GEORGE LN
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-8947
Practice Address - Country:US
Practice Address - Phone:202-651-0819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1917913251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health