Provider Demographics
NPI:1336337872
Name:NADA, ADEL ALY (PT)
Entity Type:Individual
Prefix:
First Name:ADEL
Middle Name:ALY
Last Name:NADA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 E 56TH ST
Mailing Address - Street 2:STE 120
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46216-1023
Mailing Address - Country:US
Mailing Address - Phone:317-337-6400
Mailing Address - Fax:
Practice Address - Street 1:1251 W 96TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1181
Practice Address - Country:US
Practice Address - Phone:317-407-5361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005490A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist