Provider Demographics
NPI:1396330866
Name:ABDULRAZACK, ADNAN
Entity type:Individual
Prefix:
First Name:ADNAN
Middle Name:
Last Name:ABDULRAZACK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-3505
Mailing Address - Country:US
Mailing Address - Phone:443-410-8994
Mailing Address - Fax:
Practice Address - Street 1:7801 YORK RD STE 335
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7449
Practice Address - Country:US
Practice Address - Phone:410-343-9469
Practice Address - Fax:443-213-1100
Is Sole Proprietor?:No
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician