Healthcare Provider Details

I. General information

NPI: 1609796713
Provider Name (Legal Business Name): RIM Z ABDULLAH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 09/30/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 EAST ADAMS STREET 4TH FLOOR
SYRACUSE NY
13210-2576
US

IV. Provider business mailing address

251 SALINA STE 100
SYRACUSE NY
13210
US

V. Phone/Fax

Practice location:
  • Phone: 315-464-5240
  • Fax: 315-464-7327
Mailing address:
  • Phone: 315-464-2096
  • Fax: 315-464-2010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number357377
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number357377
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number839577-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: