MEDICARE: HIKMA ABDULGHANI

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	163W00000X	Registered Nurse	704136	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	704136	OTHER	NY	NYS OFFICE OF PROFESSIONS

General Provider Information

NPI Number	:	1306304597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIKMA ABDULGHANI

Provider Business Mailing Address
First Line	:	201 CLINTON AVE APT 9F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	201 CLINTON AVE APT 9F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11205-3565
Country	:	US
Telephone Number	:	718-200-8249
Fax Number	:

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

Provider Enumeration Date	:	03/06/2019
Last Update Date	:	03/06/2019

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