Provider Demographics
NPI:1669360293
Name:ABDELGHANI, USAMA Y
Entity type:Individual
Prefix:
First Name:USAMA
Middle Name:Y
Last Name:ABDELGHANI
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 1:5914 TORIA DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3792
Mailing Address - Country:US
Mailing Address - Phone:337-303-3184
Mailing Address - Fax:
Practice Address - Street 1:5914 TORIA DR
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-3792
Practice Address - Country:US
Practice Address - Phone:337-303-3184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008515883172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver