MEDICARE: MS. BADRIYYAH A. SALAAM CPT, CCMA, NOTARY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251G00000X	Community Based Hospice Care Agency
2	372600000X	Adult Companion
3	374700000X	Technician
4	390200000X	Student in an Organized Health Care Education/Training Program
5	374J00000X	Doula

General Provider Information

NPI Number	:	1801676549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BADRIYYAH A. SALAAM CPT, CCMA, NOTARY

Provider Business Mailing Address
First Line	:	1812 BLUEFIELD PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3514
Country	:	US
Telephone Number	:	760-673-5618
Fax Number	:

Provider Business Practice Location Address
First Line	:	1812 BLUEFIELD PL
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45237-3514
Country	:	US
Telephone Number	:	760-673-5618
Fax Number	:

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

Provider Enumeration Date	:	10/02/2023
Last Update Date	:	10/02/2023

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