MEDICARE: SEIKO IYAMA PC

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	101YP2500X	Professional Counselor	PC007876	PA

General Provider Information

NPI Number	:	1700281326
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEIKO IYAMA PC

Provider Business Mailing Address
First Line	:	1229 S 20TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2946
Country	:	US
Telephone Number	:	267-422-2881
Fax Number	:

Provider Business Practice Location Address
First Line	:	1229 S 20TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-2946
Country	:	US
Telephone Number	:	267-422-2881
Fax Number	:

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

Provider Enumeration Date	:	10/24/2014
Last Update Date	:	10/14/2022

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Directions to “ SEIKO IYAMA PC” Practice Location

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