Provider Demographics
NPI:1063162667
Name:MUHANNAD, TYREEMA L
Entity type:Individual
Prefix:
First Name:TYREEMA
Middle Name:L
Last Name:MUHANNAD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 WRIGHT ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07114-1825
Mailing Address - Country:US
Mailing Address - Phone:973-600-7106
Mailing Address - Fax:
Practice Address - Street 1:117 WRIGHT ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07114-1825
Practice Address - Country:US
Practice Address - Phone:973-600-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula