Provider Demographics
NPI:1235731803
Name:AL-JABER, HANIN N I
Entity type:Individual
Prefix:
First Name:HANIN
Middle Name:N
Last Name:AL-JABER
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18139 COLGATE ST
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48125-3313
Mailing Address - Country:US
Mailing Address - Phone:313-335-7211
Mailing Address - Fax:
Practice Address - Street 1:18139 COLGATE ST
Practice Address - Street 2:
Practice Address - City:DEARBORN HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48125-3313
Practice Address - Country:US
Practice Address - Phone:313-335-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIA421298622091156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist