Healthcare Provider Details

I. General information

NPI: 1083578108
Provider Name (Legal Business Name): NADIA S MOBARAK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

5892 AQUA BAY DR
COLUMBUS OH
43235-7502
US

IV. Provider business mailing address

5892 AQUA BAY DR
COLUMBUS OH
43235-7502
US

V. Phone/Fax

Practice location:
  • Phone: 614-948-9929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number602825820524
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: