Healthcare Provider Details

I. General information

NPI: 1942888284
Provider Name (Legal Business Name): SILVANA LOKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2021
Last Update Date: 10/04/2022
Certification Date: 10/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 WINDRIM AVE
PHILADELPHIA PA
19141-2710
US

IV. Provider business mailing address

125 HUNTER WAY
CHALFONT PA
18914-2014
US

V. Phone/Fax

Practice location:
  • Phone: 215-455-3900
  • Fax:
Mailing address:
  • Phone: 267-528-6181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS019723
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: