Provider Demographics
NPI:1104701028
Name:MOHAMED, SAYIDALI ABDULLAHI
Entity type:Individual
Prefix:
First Name:SAYIDALI
Middle Name:ABDULLAHI
Last Name:MOHAMED
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:763 WINNETKA AVE N
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55427-4529
Mailing Address - Country:US
Mailing Address - Phone:612-946-2325
Mailing Address - Fax:
Practice Address - Street 1:393 DUNLAP ST N STE 861
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4204
Practice Address - Country:US
Practice Address - Phone:651-666-3291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician