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Individual

MR. FADOUL BRAHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
147 PRINCE ST, BROOKLYN, NY 11201-3007
(718) 374-5949
Mailing address
1329 COLLEGE AVE APT 5A, BRONX, NY 10456-1543

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
643667501
NY STATE DRIVER'S LICENSE
NY
05
MV15418U
NY
Enumeration date
10/09/2017
Last updated
10/09/2017
About Stedi
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Product
  • Claims
  • Eligibility checks
  • EDI platform