MEDICARE: RAWAN ATEF EBRAHIM

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	RN2386685	MA

General Provider Information

NPI Number	:	1750270518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAWAN ATEF EBRAHIM

Provider Business Mailing Address
First Line	:	34 FRANKLIN ST
Second Line	:
City	:	FEEDING HILLS
State	:	MA
Zip	:	01030-2333
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	34 FRANKLIN ST
Second Line	:
City	:	FEEDING HILLS
State	:	MA
Zip	:	01030-2333
Country	:	US
Telephone Number	:	413-977-6097
Fax Number	:

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

Provider Enumeration Date	:	06/28/2025
Last Update Date	:	06/30/2025

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