Provider Demographics
NPI:1669341749
Name:ABDALLAH, SAEED KHALIFA
Entity type:Individual
Prefix:
First Name:SAEED
Middle Name:KHALIFA
Last Name:ABDALLAH
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 1:1225 RAYMOND BLVD UNIT 303
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07102-2943
Mailing Address - Country:US
Mailing Address - Phone:347-484-7632
Mailing Address - Fax:
Practice Address - Street 1:1225 RAYMOND BLVD UNIT 303
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07102-2943
Practice Address - Country:US
Practice Address - Phone:347-484-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-05
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty