1326613241 NPI number — ASMAA IBRAHIM HASSAN ABD EL REHIM M.D.

Table of content: SUMMER K SMITH (NPI 1659028645)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326613241 NPI number — ASMAA IBRAHIM HASSAN ABD EL REHIM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABD EL REHIM
Provider First Name:
ASMAA
Provider Middle Name:
IBRAHIM HASSAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326613241
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
11/14/2022
NPI Reactivation Date:
07/20/2023

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
79-01 BROADWAY
Provider Second Line Business Mailing Address:
ROOM C10-12.
Provider Business Mailing Address City Name:
ELMHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-334-3542
Provider Business Mailing Address Fax Number:
718-334-3441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
79-01 BROADWAY
Provider Second Line Business Practice Location Address:
ROOM C10-12. ELMHURST
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11373
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-334-3542
Provider Business Practice Location Address Fax Number:
718-334-3441
Provider Enumeration Date:
05/24/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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