Provider Demographics
NPI:1881870525
Name:RAAFAT I ATTIA HANNA MD PC
Entity type:Organization
Organization Name:RAAFAT I ATTIA HANNA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAAFAT
Authorized Official - Middle Name:I
Authorized Official - Last Name:ATTIA HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-747-0041
Mailing Address - Street 1:110 LONG POND RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2642
Mailing Address - Country:US
Mailing Address - Phone:508-747-0041
Mailing Address - Fax:508-747-0059
Practice Address - Street 1:110 LONG POND RD
Practice Address - Street 2:SUITE 110
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2642
Practice Address - Country:US
Practice Address - Phone:508-747-0041
Practice Address - Fax:508-747-0059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-11
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
72108207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9781706Medicaid
MA072108OtherTUFTS
MAM16740OtherBLUE CROSS BLUE SHEILD
MA1881870525OtherAETNA
MA0003642Medicare PIN