Healthcare Provider Details

I. General information

NPI: 1952503310
Provider Name (Legal Business Name): NAKISBENDI & ASSOCIATES, LLC., PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2007
Last Update Date: 09/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 E LANCASTER AVE SUITE 103
ARDMORE PA
19003-2321
US

IV. Provider business mailing address

233 E LANCASTER AVE SUITE 103
ARDMORE PA
19003-2321
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-1330
  • Fax: 610-642-1344
Mailing address:
  • Phone: 610-642-1330
  • Fax: 610-642-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberMD065510L
License Number StatePA

VIII. Authorized Official

Name: DR. KARA M NAKISBENDI
Title or Position: PRESIDENT
Credential: MD
Phone: 610-642-1330