MEDICARE: SUMAYYA ABOOBACKER

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	390200000X	Student in an Organized Health Care Education/Training Program		OH
2	207L00000X	Anesthesiology Physician	57.254063	OH

General Provider Information

NPI Number	:	1568219848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUMAYYA ABOOBACKER

Provider Business Mailing Address
First Line	:	9500 EUCLID AVE # JJ24
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0002
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

Provider Business Practice Location Address
First Line	:	9500 EUCLID AVE # JJ24
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44195-0002
Country	:	US
Telephone Number	:	216-444-2200
Fax Number	:

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

Provider Enumeration Date	:	05/03/2024
Last Update Date	:	05/10/2026

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Directions to “ SUMAYYA ABOOBACKER ” Practice Location

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