Provider Demographics
NPI:1912451634
Name:ALAZZAWI, IMAN
Entity type:Individual
Prefix:
First Name:IMAN
Middle Name:
Last Name:ALAZZAWI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1779 TREMAINSVILLE RD APT 223
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-4029
Mailing Address - Country:US
Mailing Address - Phone:419-367-4034
Mailing Address - Fax:
Practice Address - Street 1:1779 TREMAINSVILLE RD APT 223
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-4029
Practice Address - Country:US
Practice Address - Phone:419-367-4034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHUF152374163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health