Provider Demographics
NPI:1770756710
Name:SAAD, ISMAIL RADY
Entity type:Individual
Prefix:
First Name:ISMAIL
Middle Name:RADY
Last Name:SAAD
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 1:6123 BROOKVIEW PL
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-2812
Mailing Address - Country:US
Mailing Address - Phone:856-366-6152
Mailing Address - Fax:215-214-1734
Practice Address - Street 1:333 COTTMAN AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19111-2434
Practice Address - Country:US
Practice Address - Phone:215-728-3564
Practice Address - Fax:215-214-1734
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-10
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program