Provider Demographics
NPI:1841036506
Name:GHENTAWI, RAHAF
Entity type:Individual
Prefix:
First Name:RAHAF
Middle Name:
Last Name:GHENTAWI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RAHAF
Other - Middle Name:
Other - Last Name:GHENTAWI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:8338 WOODGROVE CT
Mailing Address - Street 2:
Mailing Address - City:SUGARCREEK TOWNSHIP
Mailing Address - State:OH
Mailing Address - Zip Code:45458-1823
Mailing Address - Country:US
Mailing Address - Phone:937-979-0704
Mailing Address - Fax:
Practice Address - Street 1:8338 WOODGROVE CT
Practice Address - Street 2:
Practice Address - City:SUGARCREEK TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:45458-1823
Practice Address - Country:US
Practice Address - Phone:937-979-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH202418402810343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)