Provider Demographics
NPI:1316587884
Name:YAHYA, ABDALGHANI A
Entity type:Individual
Prefix:DR
First Name:ABDALGHANI
Middle Name:A
Last Name:YAHYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 CARY ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NH
Mailing Address - Zip Code:03773-1479
Mailing Address - Country:US
Mailing Address - Phone:916-595-5477
Mailing Address - Fax:
Practice Address - Street 1:42 CARY ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1479
Practice Address - Country:US
Practice Address - Phone:916-595-5477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2024-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT040.0134707225100000X
NY044229225100000X
NH4738225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHNHL15379927OtherDRIVER LICENSE