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NPI Code Detail

MEDICARE: MS. ALYA ABDU BARAKA

MEDICARE: MS. ALYA ABDU BARAKA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy AssistantA2834MD
2225200000XPhysical Therapy AssistantA-0506NV

General Provider Information

NPI Number : 1083864631
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALYA ABDU BARAKA
Provider Business Mailing Address
First Line : 3370 SAINT ROSE PKWY
Second Line : APT 2417
City : HENDERSON
State : NV
Zip : 89052-4182
Country : US
Telephone Number : 702-434-7376
Fax Number :
Provider Business Practice Location Address
First Line : 2250 E FLAMINGO RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5170
Country : US
Telephone Number : 702-784-4300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/19/2008
Last Update Date : 05/25/2011

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