Provider Demographics
NPI:1902364102
Name:ABDELHADI, KAAMILYA
Entity Type:Individual
Prefix:MRS
First Name:KAAMILYA
Middle Name:
Last Name:ABDELHADI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2812 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-3509
Mailing Address - Country:US
Mailing Address - Phone:251-423-5292
Mailing Address - Fax:
Practice Address - Street 1:2812 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-3509
Practice Address - Country:US
Practice Address - Phone:251-423-5292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-06
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC4099343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALHL2SQJAYZMedicaid
ALC4099OtherAPSC
ALB-88Medicaid