Provider Demographics
NPI:1053623470
Name:ALHABACH, P.C.
Entity type:Organization
Organization Name:ALHABACH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HOSSAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ALHABACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-315-9820
Mailing Address - Street 1:PO BOX 45378
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85064-5378
Mailing Address - Country:US
Mailing Address - Phone:602-315-9820
Mailing Address - Fax:
Practice Address - Street 1:120 E RIO SALADO PKWY
Practice Address - Street 2:#504
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281
Practice Address - Country:US
Practice Address - Phone:602-315-9820
Practice Address - Fax:480-275-7467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-14
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ334872084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty