Healthcare Provider Details

I. General information

NPI: 1689578411
Provider Name (Legal Business Name): DR. HUTHAIFA ABABNEH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 LORAIN AVE
CLEVELAND OH
44111-5612
US

IV. Provider business mailing address

20201 LORAIN RD APT 809
FAIRVIEW PARK OH
44126-3476
US

V. Phone/Fax

Practice location:
  • Phone: 216-476-7000
  • Fax:
Mailing address:
  • Phone: 216-288-9632
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number57.260205
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: