Provider Demographics
NPI:1962208686
Name:MOHAMED, HAMDI ALI
Entity type:Individual
Prefix:
First Name:HAMDI
Middle Name:ALI
Last Name:MOHAMED
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 1:800 RIVERVIEW DR APT 2023
Mailing Address - Street 2:
Mailing Address - City:SOUTH SIOUX CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68776-3534
Mailing Address - Country:US
Mailing Address - Phone:402-359-0634
Mailing Address - Fax:402-359-0634
Practice Address - Street 1:800 RIVERVIEW DR APT 2023
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3534
Practice Address - Country:US
Practice Address - Phone:402-359-0634
Practice Address - Fax:402-359-0634
Is Sole Proprietor?:No
Enumeration Date:2025-02-22
Last Update Date:2025-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747P1801X
NE372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant