Basic Information
| Provider Information | |||||||||
| NPI: | 1619199577 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GEADAH | ||||||||
| FirstName: | ADIB | ||||||||
| MiddleName: | F. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | AUDIOLOGIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8800 SE SUNNYSIDE RD STE 300N | ||||||||
| Address2: | |||||||||
| City: | CLACKAMAS | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970155703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812862999 | ||||||||
| FaxNumber: | 5126074893 | ||||||||
| Practice Location | |||||||||
| Address1: | 33 STATE RD STE B&C | ||||||||
| Address2: | |||||||||
| City: | PRINCETON | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085401304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6099240534 | ||||||||
| FaxNumber: | 6099248636 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AT000968L | PA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.