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General NPI Number Information
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NPI Number | 1508369851
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Entity Type | Organization
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Legal Business Name | EL-HALLAK RHEUMATOLOGY AND SPECIALTY INFUSION SERVICES LLC
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Dates
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Enumeration Date | 03/13/2018
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Last Update Date | 07/06/2021
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Provider Practice Location Address
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Address Line | 23215 COMMERCE PARK STE 318
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City | BEACHWOOD
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State | OH
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Zip | 44122-5803
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Country | US
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Telephone | 216-755-4044
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Fax | 330-967-0571
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Provider Business Mailing Address
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Address Line | 23215 COMMERCE PARK STE 318
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City | BEACHWOOD
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State | OH
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Zip | 44122-5803
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Country | US
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Telephone | 216-755-4044
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Fax | 330-967-0571
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Authorized Official
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Title or Position | OWNER/AUTHORIZED OFFICIAL
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Name | MOUSSA EL-HALLAK
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Credential | MD
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Telephone | 216-755-4044
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0216X
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Taxonomy Name | Pediatric Rheumatology Physician
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License Number | 35.129222
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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