Mohammad Adnan Abduldaem Abu-Abaa
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Trenton, NJ
NPI 1629643689 · NPPES record last updated May 22, 2021
Key facts
- NPI
- 1629643689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 750 Brunswick Ave
Trenton, NJ 08638-4143 - Phone
- (609) 339-4603
- NPI assigned
- May 22, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
- 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 |
|---|---|---|---|---|
| I20230503003163 | WA | Order and Referring Only - Neurology |
6901261569 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
750 Brunswick Ave
Trenton, NJ 08638-4143
Mailing address
750 Brunswick Ave
Trenton, NJ 08638-4143
Phone (609) 339-4603
Other providers in Trenton, NJ
- Ameen Hasan Abdullah
- El-Shabazz U. Abdullah
- Abiding Love International Fellowship
- Claude Abouchedid
- Marwa Hussein Aly Abu Elezz
- Malik Abubakar
- Alfredo Ramon Abud
- Lincy Aby
- Accupath Diagnostic Laboratories, Inc.
- Acme Markets Inc
All providers in Trenton, NJ · Student in an Organized Health Care Education/Training Program in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2021. 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.