Healthcare Provider Details

I. General information

NPI: 1730971250
Provider Name (Legal Business Name): RADWA MEDHAT SAYED AHMED ABDELRAHMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 PROSPECT AVENUE
HACKENSACK NJ
07601
US

IV. Provider business mailing address

30 PROSPECT HMH HACKENSACK UNIVERSITY MEDICAL CENTER, AVENUE HACKENSACK, NJ
HACKENSACK NJ
07601
US

V. Phone/Fax

Practice location:
  • Phone: 646-330-8520
  • Fax:
Mailing address:
  • Phone: 646-330-8520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: