Provider Demographics
NPI:1194170647
Name:ELNAJJAR, ALAA (MD)
Entity type:Individual
Prefix:
First Name:ALAA
Middle Name:
Last Name:ELNAJJAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 VETERANS MEMORIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-5099
Mailing Address - Country:US
Mailing Address - Phone:401-432-1137
Mailing Address - Fax:401-432-1509
Practice Address - Street 1:1011 VETERANS MEMORIAL PKWY
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:RI
Practice Address - Zip Code:02915-5099
Practice Address - Country:US
Practice Address - Phone:401-432-1137
Practice Address - Fax:401-432-1509
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3025832084P0800X
390200000X
RIMD176792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program