Provider Demographics
NPI:1700673399
Name:AL AZZAWI, RAYA A (AEGD, BDS, MSC)
Entity type:Individual
Prefix:
First Name:RAYA
Middle Name:A
Last Name:AL AZZAWI
Suffix:
Gender:F
Credentials:AEGD, BDS, MSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CROWN DR UNIT 101
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5474
Mailing Address - Country:US
Mailing Address - Phone:469-810-6492
Mailing Address - Fax:
Practice Address - Street 1:1 CROWN DR UNIT 101
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5474
Practice Address - Country:US
Practice Address - Phone:469-810-6492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program