Provider Demographics
NPI:1811240914
Name:HAADOOW, HAMZA A
Entity type:Individual
Prefix:
First Name:HAMZA
Middle Name:A
Last Name:HAADOOW
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 1:1 COAST LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-2844
Mailing Address - Country:US
Mailing Address - Phone:207-228-0697
Mailing Address - Fax:
Practice Address - Street 1:203 ANDERSON ST STE 1A
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-2596
Practice Address - Country:US
Practice Address - Phone:207-773-1400
Practice Address - Fax:800-531-7680
Is Sole Proprietor?:No
Enumeration Date:2012-10-26
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No374U00000XNursing Service Related ProvidersHome Health Aide