Healthcare Provider Details

I. General information

NPI: 1437850369
Provider Name (Legal Business Name): HADE DABBAGH PMHNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ABDEL HADE DABBAGH RN

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 CENTRAL ST
LEOMINSTER MA
01453-4805
US

IV. Provider business mailing address

1069 CENTRAL ST
LEOMINSTER MA
01453-4805
US

V. Phone/Fax

Practice location:
  • Phone: 978-728-4957
  • Fax: 978-798-1366
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2025002245
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN2356181
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: