Healthcare Provider Details

I. General information

NPI: 1104758283
Provider Name (Legal Business Name): TAGREED AL-ABED PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAGREED ALABED PA-C

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1155 MAIN ST APT 546
BUFFALO NY
14209-2384
US

IV. Provider business mailing address

1300 MIDLAND AVE APT A74
YONKERS NY
10704-1416
US

V. Phone/Fax

Practice location:
  • Phone: 914-319-7282
  • Fax:
Mailing address:
  • Phone: 914-319-7282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: