NPI 1245997105 · live from the CMS NPI Registry
Kifah Khair Abedrabbo
Physician Assistant in West Caldwell, NJ. National Provider Identifier 1245997105, active.
NPI record
| NPI | 1245997105 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 252 Clinton Rd, West Caldwell, NJ 07006 |
| Practice phone | 862-262-0113 |
| Enumerated | November 25, 2021 |
| Last updated | January 19, 2024 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Physician Assistant primary | 363A00000X | 25MP00805400 (NJ) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.