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General NPI Number Information
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NPI Number | 1790373926
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Entity Type | Individual
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Provider Name | IFRAH ABDIRAHMAN
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Gender | Female
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Dates
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Enumeration Date | 01/04/2021
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 179 N BROAD ST
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City | NORWICH
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State | NY
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Zip | 13815-1019
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Country | US
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Telephone | 443-603-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 179 N BROAD ST
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City | NORWICH
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State | NY
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Zip | 13815-1019
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Country | US
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Telephone | 443-603-8272
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Fax |
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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 | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 75402
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 171208
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RA0001X
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Taxonomy Name | Advanced Heart Failure and Transplant Cardiology Physician
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License Number | 336091-01
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License Number State | NY
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