HABEEBA SIRAJUDDIN (NPI# 1942695440) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942695440 |
| Entity Type | Individual |
| Full Name | HABEEBA SIRAJUDDIN |
| Practice Address |
1345 W Central Park Ave Davenport IA 52804-1844 |
| Mailing Address |
3394 E Kimberly Rd Apt 158 Davenport IA 52807-2527 |
| Practice Telephone | 5634214400 |
| Practice Fax Number | 5634214449 |
| Mailing Telephone | 6303139466 |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2016-06-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1345 W CENTRAL PARK AVE |
| City | DAVENPORT |
| State | IA |
| Zip Code | 52804-1844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396740361 | Andrew A Andresen | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2005-06-16 |
| 1790309508 | Jenna Sarantakos | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2020-06-08 |
| 1710501549 | Kubat Rahatbeck | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2020-06-08 |
| 1629692553 | Ronald Joseph White | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2020-06-06 |
| 1578187514 | Emily Ann Gudenkauf | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2020-06-05 |
| 1457974347 | Kyle Edward Carver | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2020-05-26 |
| 1184244584 | Mary Ann Defrance | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2020-04-26 |
| 1962061242 | Avigdor Gregory Asner | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2019-06-10 |
| 1205495736 | Alison Fraehlich | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2019-06-09 |
| 1649839465 | Swarna Latha Masala | Family Medicine | 1345 W Central Park Ave, Davenport, IA 52804-1844 | 2019-06-06 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265948467 | Tess Nelson | Physical Medicine & Rehabilitation | 2535 Maplecrest Rd Suite 23, Bettendorf, IA 52804 | 2017-12-26 |
| 1124494380 | Erica Lauren Hempel Bucy | Social Worker | 1333 W. Lombard St. Ste C, Davenport, IA 52804 | 2015-08-11 |
| 1477859890 | Kristin L West | Registered Nurse | 1441 W. Centrral Park Ave, Vera French Community Mental Health Center, Davenport, IA 52804 | 2011-02-02 |
| 1679877625 | Linda Marie Crownover-inch | Doula | 1420 W 16th Street, #412, Davenport, IA 52804 | 2011-01-05 |
| 1124169032 | Lawrence R Huber | Dentist | 2305 Jersey Ridge Rd, Davenport, IA 52804 | 2007-02-12 |
| 1669532388 | Providence Therapy Services LLC | Physical Therapist | 21037 Holden Drive, Davenport, IA 52804 | 2006-12-11 |
| 1639183171 | Megan Denise Long | Occupational Therapist | 31037 Holden Dr, Davenport, IA 52804 | 2006-07-28 |
| 1811919772 | Theresa L Schlabach | Occupational Therapist | 21037 Holden Dr, Davenport, IA 52804 | 2006-07-23 |
| 1225097843 | William M Nissen | Psychiatry & Neurology | 1441 W Central Park, Davenport, IA 52804 | 2006-03-22 |
| 1245721851 | Mackenzie J Banwart | Physical Therapist | 1700 N Division St Ste 200, Davenport, IA 52804 | 2018-05-21 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346869179 | Zachary Austin Earl Thiesing | Student in an Organized Health Care Education/Training Program | 325 Via Del Sol Dr, Davenport, FL 33896-6624 | 2020-04-12 |
| 1740839042 | Jason Zinnel | Student in an Organized Health Care Education/Training Program | 3438 Washington St, Davenport, IA 52806-5608 | 2019-09-09 |
| 1932758265 | Ellyn Joy Watters | Student in an Organized Health Care Education/Training Program | 3501 Jersey Ridge Rd Apt 704, Davenport, IA 52807-2248 | 2019-09-09 |
| 1710533047 | Devin Stane | Student in an Organized Health Care Education/Training Program | 7211 Cedar St, Davenport, IA 52806-1113 | 2019-08-13 |
| 1023570801 | Amanda Campbell | Student in an Organized Health Care Education/Training Program | 764 Lobelia Dr, Davenport, FL 33837-9122 | 2019-04-02 |
| 1851879183 | Shyanne Saladino | Student in an Organized Health Care Education/Training Program | 3512 N Pine St, Davenport, IA 52806-5256 | 2018-07-30 |
| 1851802276 | Sam Xavier Funk | Student in an Organized Health Care Education/Training Program | 1536 W Central Park Ave, Davenport, IA 52804-1741 | 2017-10-12 |
| 1073907317 | Austin Smith | Student in an Organized Health Care Education/Training Program | 2216 W 30th St, Davenport, IA 52804-1408 | 2015-03-25 |
| 1205063096 | Ryan Bobst | Student in an Organized Health Care Education/Training Program | 1229 W 8th St, Davenport, IA 52802-1331 | 2009-06-18 |
| 1720695307 | Jordan Barber | Student in an Organized Health Care Education/Training Program | 1320 W Lombard St, Davenport, IA 52804-2029 | 2020-09-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.