Healthcare Provider Details

I. General information

NPI: 1396650511
Provider Name (Legal Business Name): LANA ABUDAHRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2576 BOND AVE
DREXEL HILL PA
19026-1602
US

IV. Provider business mailing address

2576 BOND AVE
DREXEL HILL PA
19026-1602
US

V. Phone/Fax

Practice location:
  • Phone: 484-535-2352
  • Fax:
Mailing address:
  • Phone: 484-535-2352
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP460566
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: