Fnu Amatur Rabbal Mashariq

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MT234370 Issued in PA

Practice address

30 N 4TH St
Lebanon, PA 17046-5606

Phone

(717) 274-0474

NPI assigned

Jul 19, 2025

Last updated

Jul 19, 2025By the provider in NPPES

Sex

Unspecified or another gender identity

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 PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• 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": "1752883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752883200000",
    "number": "1710879010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606",
            "telephone_number": "717-274-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 4TH ST",
            "city": "LEBANON",
            "state": "PA",
            "postal_code": "170465606",
            "telephone_number": "717-274-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMATUR RABBAL MASHARIQ",
        "first_name": "FNU",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-19",
        "last_updated": "2025-07-19",
        "certification_date": "2025-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT234370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alpine Valley Operator LLC (Alpine Valley Post Acute and Healthcare Center)
• Maria Alpoyanis, LMHC, MA, LPC
• Janine Grace Alrutz, MT-BC
• Eugene William Althouse Jr.
• Alejandro J Alvarez, MDIV
• Judi Amberg
• Kelly Patricia Ament, CRNP
• American Home Medical Equipment Co.,LLC
• American Homecare Supply Company
• Jaclyn Amey, PHARMD

• Family Medicine Physician in Lebanon, PA
• Providers in Lebanon, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2025; 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.