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NPI Code Detail

MEDICARE: DIVYA LAL

MEDICARE: DIVYA LAL
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
11835P0018XPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist453965PA

General Provider Information

NPI Number : 1386295525
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIVYA LAL
Provider Business Mailing Address
First Line : 225 S 42ND ST APT 2C
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-3518
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 338 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-2321
Country : US
Telephone Number : 215-634-4397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2019
Last Update Date : 09/27/2019

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Directions to “ DIVYA LAL ” Practice Location

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