Provider Demographics
NPI:1801454483
Name:HARRAK, FATIHA
Entity type:Individual
Prefix:
First Name:FATIHA
Middle Name:
Last Name:HARRAK
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 1:404 CRAVEN ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23661-2632
Mailing Address - Country:US
Mailing Address - Phone:757-367-9113
Mailing Address - Fax:
Practice Address - Street 1:404 CRAVEN ST
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23661-2632
Practice Address - Country:US
Practice Address - Phone:757-367-9113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)