MEDICARE: DR. AHMED M. ABDELAL PH.D., CCC

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	235Z00000X	Speech-Language Pathologist	5203	MA

General Provider Information

NPI Number	:	1689718876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AHMED M. ABDELAL PH.D., CCC

Provider Business Mailing Address
First Line	:	27 HUNTINGTON RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4714
Country	:	US
Telephone Number	:	508-732-0109
Fax Number	:	508-747-6222

Provider Business Practice Location Address
First Line	:	27 HUNTINGTON RD
Second Line	:
City	:	PLYMOUTH
State	:	MA
Zip	:	02360-4714
Country	:	US
Telephone Number	:	508-732-0109
Fax Number	:	508-747-6222

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	07/08/2007

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