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General NPI Number Information
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NPI Number | 1528991866
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Entity Type | Organization
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Legal Business Name | REACH POTENTIAL LLC
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 6 HENRY PL
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City | STATEN ISLAND
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State | NY
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Zip | 10305-1317
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Country | US
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Telephone | 347-980-4112
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Fax |
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Provider Business Mailing Address
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Address Line | 418 BROADWAY STE 8587
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City | ALBANY
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State | NY
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Zip | 12207-2922
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Country | US
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Telephone | 347-980-4112
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. MARYHAN ABDELAZIM
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Credential | PHD
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Telephone | 929-310-0057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1800X
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Taxonomy Name | Corporate Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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