MEDICARE: RASHIDAH LORRAINE ABDUL-KHABEER RN, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1500X	Community Health Registered Nurse	181815-L	PA

General Provider Information

NPI Number	:	1295179042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHIDAH LORRAINE ABDUL-KHABEER RN, PHD

Provider Business Mailing Address
First Line	:	6425 N CAMAC ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19126-3644
Country	:	US
Telephone Number	:	215-432-6691
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 MARKET ST
Second Line	:	SUITE 1800
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3913
Country	:	US
Telephone Number	:	216-985-2606
Fax Number	:	215-985-2646

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	04/23/2013

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