Provider Demographics
NPI:1730409327
Name:ALHUMAIDAN, HIBA (MD)
Entity type:Individual
Prefix:
First Name:HIBA
Middle Name:
Last Name:ALHUMAIDAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 YORK STREET
Mailing Address - Street 2:CB-459
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06504
Mailing Address - Country:US
Mailing Address - Phone:203-688-2450
Mailing Address - Fax:203-668-7340
Practice Address - Street 1:20 YORK ST
Practice Address - Street 2:CB-459
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-3220
Practice Address - Country:US
Practice Address - Phone:203-688-2441
Practice Address - Fax:203-688-2748
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RILP01826207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology