Healthcare Provider Details

I. General information

NPI: 1659579100
Provider Name (Legal Business Name): KALTRA XHAFAJ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2007
Last Update Date: 08/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 CHERRY ST
PHILADELPHIA PA
19102-1321
US

IV. Provider business mailing address

1105 E CHELTEN AVE
PHILADELPHIA PA
19138-1821
US

V. Phone/Fax

Practice location:
  • Phone: 877-882-7820
  • Fax:
Mailing address:
  • Phone: 267-595-2579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP441781
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: