Lina Ziad Khali Al-Bawaliz

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

14175 Issued in CT

Practice address

263 Farmington Avenue
Farmington, CT 06030

Phone

(263) 060-3086

NPI assigned

Jul 5, 2024

Last updated

Jul 23, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1104662543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06030",
            "telephone_number": "263-060-3086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-BAWALIZ",
        "first_name": "LINA",
        "middle_name": "ZIAD KHALI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "14175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Majd Al Masri, MD
• Dina Al Rameni
• Fatmah Al Zahmi, MBBS
• Khadijeh Al-Abedalla
• Sharefa Sulaiman Al-Asfour
• Ammr Al-Houssan, MBBCH
• Wahila Alam, M.D.
• Amer Zaal Alanezi, DDS
• Gwen Torvy Beaman Alber, DO
• Peter C Albertsen, M.D.

• Student in an Organized Health Care Education/Training Program in Farmington, CT
• Providers in Farmington, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.