Healthcare Provider Details

I. General information

NPI: 1124848023
Provider Name (Legal Business Name): FALAK MDAHI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2024
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 STATE HILL RD
WYOMISSING PA
19610-1432
US

IV. Provider business mailing address

2800 STATE HILL RD
WYOMISSING PA
19610-1432
US

V. Phone/Fax

Practice location:
  • Phone: --
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP459019
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: