Healthcare Provider Details

I. General information

NPI: 1801444138
Provider Name (Legal Business Name): KORAH CONSULTING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 08/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11934 DUMONT RD
PHILADELPHIA PA
19116-2319
US

IV. Provider business mailing address

11934 DUMONT RD
PHILADELPHIA PA
19116-2319
US

V. Phone/Fax

Practice location:
  • Phone: 267-391-6138
  • Fax:
Mailing address:
  • Phone: 267-391-6138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SHEELA KORAH
Title or Position: OWNER
Credential: CRNP
Phone: 267-391-6138