Provider Demographics
NPI:1467501783
Name:HANAFY, RASHA (DO)
Entity type:Individual
Prefix:
First Name:RASHA
Middle Name:
Last Name:HANAFY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BOYNTON BROOK RD
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-9379
Mailing Address - Country:US
Mailing Address - Phone:207-489-7000
Mailing Address - Fax:207-781-0004
Practice Address - Street 1:15 SKY VIEW DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND FORESIDE
Practice Address - State:ME
Practice Address - Zip Code:04110-1472
Practice Address - Country:US
Practice Address - Phone:207-489-7000
Practice Address - Fax:207-781-0004
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1713204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME404140099Medicaid
MEME0460Medicare ID - Type Unspecified
ME404140099Medicaid