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General NPI Number Information
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NPI Number | 1467703231
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Entity Type | Individual
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Provider Name | RAED YABROUDI
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Gender | Male
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 11/27/2022
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Provider Practice Location Address
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Address Line | 886 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07503-2637
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Country | US
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Telephone | 201-428-1162
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Fax | 201-991-8400
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Provider Business Mailing Address
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Address Line | 886 MAIN ST
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City | PATERSON
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State | NJ
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Zip | 07503-2637
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Country | US
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Telephone | 201-428-1162
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Fax | 201-991-8400
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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