MEDICARE: KHALIL ALAQRABAWI

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1356176168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHALIL ALAQRABAWI

Provider Business Mailing Address
First Line	:	27 HUDSON AVE
Second Line	:
City	:	RIDGEFIELD PARK
State	:	NJ
Zip	:	07660-1724
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3221 AMAZON ST
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1430
Country	:	US
Telephone Number	:	313-472-9019
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/03/2024
Last Update Date	:	12/09/2025

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Directions to “ KHALIL ALAQRABAWI ” Practice Location

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