Hani Abdel-Rahman, DO
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Port Jefferson, NY
NPI 1366145138 · NPPES record last updated Mar 26, 2024
Key facts
- NPI
- 1366145138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 200 Belle Terre Rd
Port Jefferson, NY 11777-1928 - Phone
- (631) 474-6879
- Fax
- (631) 474-6448
- NPI assigned
- Mar 22, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230721003413 | GA | Order and Referring Only - Family Practice |
3971963950 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Mailing address
200 Belle Terre Rd
Port Jefferson, NY 11777-1928
Phone (631) 474-6879
Other practice location 1
501 Redmond Rd NW
Rome, GA 30165-1415
Phone (706) 802-3063
Other providers in Port Jefferson, NY
- Vivian Abano Bollmann
- Abby Leefer, Licensed Clinical Social Worker, PC
- Yasser K Abdelbaki
- Louanne E Abelquist
- Mohamad H Abouzeid
- Connor Abramowicz
- Advanced Gastroenterology and Endoscopy, P.C.
All providers in Port Jefferson, NY · Student in an Organized Health Care Education/Training Program in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.