Provider Demographics
NPI:1104787183
Name:ABOUBAKAR, ABDELMALIK ABOUBAKAR SR (ONER)
Entity type:Individual
Prefix:MR
First Name:ABDELMALIK
Middle Name:ABOUBAKAR
Last Name:ABOUBAKAR
Suffix:SR
Gender:M
Credentials:ONER
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:32 KNOX ST APT B8
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2111
Mailing Address - Country:US
Mailing Address - Phone:203-440-6237
Mailing Address - Fax:203-440-6237
Practice Address - Street 1:32 KNOX ST APT B8
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-2111
Practice Address - Country:US
Practice Address - Phone:203-440-6237
Practice Address - Fax:203-440-6237
Is Sole Proprietor?:No
Enumeration Date:2025-11-19
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT2395526411041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool