Provider Demographics
NPI:1982496204
Name:ABDALLA, AHMAD RIYAD (MD)
Entity type:Individual
Prefix:MR
First Name:AHMAD
Middle Name:RIYAD
Last Name:ABDALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HOUSE 25, STREET 10
Mailing Address - Street 2:BLOCK NO 2 OYOUN, JAHRA
Mailing Address - City:JAHRA
Mailing Address - State:JAHRA
Mailing Address - Zip Code:00000
Mailing Address - Country:KW
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 CASS AVENUE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895
Practice Address - Country:US
Practice Address - Phone:401-769-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program