Healthcare Provider Details

I. General information

NPI: 1609642206
Provider Name (Legal Business Name): SIHAM FOUZI A ALSOMALI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SIHAM FOUZI A ALSOMALI

II. Dates (important events)

Enumeration Date: 11/27/2023
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 CHESTER AVE APT C
PHILADELPHIA PA
19143-4381
US

IV. Provider business mailing address

5120 CHESTER AVE APT C
PHILADELPHIA PA
19143-4381
US

V. Phone/Fax

Practice location:
  • Phone: 267-271-5722
  • Fax:
Mailing address:
  • Phone: 267-271-5722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRN751361
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number432895
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: