Active NPI
Remi M Ibraheem, LIC.AC
- Acupuncturist
- Gloucester, MA
National Provider Identifier
1568752657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 226468
- Practice address
- 114 Main St
Gloucester, MA 01930-5706 - Phone
- (978) 290-6017
- NPI assigned
- Apr 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 226468 | MA | Primary |
Addresses
Primary practice location
114 Main St
Gloucester, MA 01930-5706
Mailing address
14 Centennial Ave
Unit 2
Gloucester, MA 01930-2502
Phone (978) 290-6017
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 226468 | MA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302480000000",
"number": "1568752657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 CENTENNIAL AVE",
"address_2": "UNIT 2",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019302502",
"telephone_number": "978-290-6017"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 MAIN ST",
"city": "GLOUCESTER",
"state": "MA",
"postal_code": "019305706",
"telephone_number": "978-290-6017"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IBRAHEEM",
"first_name": "REMI",
"middle_name": "M",
"name_prefix": "Miss",
"credential": "LIC.AC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-11",
"last_updated": "2011-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "MA",
"license": "226468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gloucester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.