Elmallah, Randa Kamal

Elmallah, Randa Kamal is an individual health care provider with primary practice located at 55 Fruit St , Boston MA 02114-2621. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is her primary health care specialty. Elmallah, Randa Kamal can be contacted via phone (617) 724-0288.

Contact Information

Primary practice address
55 Fruit St Boston MA 02114-2621
Phone: (617) 724-0288
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 2022029948 Missouri
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 286499 Massachusetts

Profile Details

NPI number 1376905455
LBN Legal business name Elmallah, Randa Kamal
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2016
Last updated Sep 30th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376905455 NPPES
Missouri MEDICAID 200113384

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