Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 1713 | ME |
N | 207Q00000X | Family Doctor | 1713 | ME |
NPI | 1467501783 |
---|---|
Provider Name | Rasha Hanafy |
First Address | Westbrook, ME 04092-4037 |
Second Address | Westbrook, ME 04092-4037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2007 |
Last Update Date | 09/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
404140099 | (05) | ME |
I05521 | (02) | ME |