MEDICARE: DR. ELANAH DALYAH NAFTALI DRPH, LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MF000803	PA

General Provider Information

NPI Number	:	1073911061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELANAH DALYAH NAFTALI DRPH, LMFT

Provider Business Mailing Address
First Line	:	145 W HORTTER ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19119-2707
Country	:	US
Telephone Number	:	215-498-6360
Fax Number	:

Provider Business Practice Location Address
First Line	:	6060 RIDGE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-1657
Country	:	US
Telephone Number	:	215-498-6360
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2014
Last Update Date	:	01/04/2016

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