Provider Demographics
NPI:1831512011
Name:ALQUDAH, MOHAMMAD NOUR (SLP)
Entity type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:NOUR
Last Name:ALQUDAH
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 CARNEGIE PLZ
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1000
Mailing Address - Country:US
Mailing Address - Phone:877-407-3422
Mailing Address - Fax:877-407-4329
Practice Address - Street 1:141 W 73RD ST
Practice Address - Street 2:#1N
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2916
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021224235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist