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NPI Code Detail

MEDICARE: AISHA DARK

MEDICARE:   AISHA  DARK
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
1183700000XPharmacy Technician

General Provider Information

NPI Number : 1407073307
Entity Type Code : Individual
Provider Name (Legal Business Name) : AISHA DARK
Provider Business Mailing Address
First Line : 6008 W THOMPSON ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-4436
Country : US
Telephone Number : 267-531-7724
Fax Number :
Provider Business Practice Location Address
First Line : 6008 W THOMPSON ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19151-4436
Country : US
Telephone Number : 267-531-7724
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2007
Last Update Date : 07/08/2007

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Directions to “ AISHA DARK ” Practice Location

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