Healthcare Provider Details

I. General information

NPI: 1659235166
Provider Name (Legal Business Name): ASIYA MARYAM ABDUL-ALIM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 DETROIT AVE APT 416
CLEVELAND OH
44113-2446
US

IV. Provider business mailing address

1500 DETROIT AVE APT 416
CLEVELAND OH
44113-2446
US

V. Phone/Fax

Practice location:
  • Phone: 216-389-5254
  • Fax:
Mailing address:
  • Phone: 216-389-5254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: