Individual
EBLA ABD ALRAHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(774) 442-6087
(774) 442-6060
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1019360
MA
208000000X
Pediatrics Physician
70740
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110187283A
—
MA
Enumeration date
03/05/2020
Last updated
10/01/2024
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