Provider Demographics
NPI:1649035171
Name:HASSANIN, REHAB ABDELGALIL (INTERNATIONAL MD)
Entity type:Individual
Prefix:MRS
First Name:REHAB
Middle Name:ABDELGALIL
Last Name:HASSANIN
Suffix:
Gender:F
Credentials:INTERNATIONAL MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9460 FOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:CASCADE
Mailing Address - State:CO
Mailing Address - Zip Code:80809-1504
Mailing Address - Country:US
Mailing Address - Phone:719-985-7249
Mailing Address - Fax:
Practice Address - Street 1:9460 FOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:CASCADE
Practice Address - State:CO
Practice Address - Zip Code:80809-1504
Practice Address - Country:US
Practice Address - Phone:719-985-7249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO106S00000X
106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician