MEDICARE: HANA ABDELRASOUL OTR

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	225X00000X	Occupational Therapist	018374-1	NY

General Provider Information

NPI Number	:	1609205590
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANA ABDELRASOUL OTR

Provider Business Mailing Address
First Line	:	402 85TH ST APT 5E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4725
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	402 85TH ST APT 5E
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-4725
Country	:	US
Telephone Number	:	347-447-7662
Fax Number	:

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

Provider Enumeration Date	:	11/01/2013
Last Update Date	:	11/01/2013

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