Individual
AIDA MALLOUHI HANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D..
Contact information
Practice address
130 QUINCY AVE, BROCKTON, MA 02302-2803
(508) 941-7268
(508) 894-0412
Mailing address
130 QUINCY AVE, BROCKTON, MA 02302-2803
(508) 941-7268
(508) 894-0412
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
203922
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2031558
—
MA
Enumeration date
06/28/2006
Last updated
01/12/2024
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