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General NPI Number Information
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NPI Number | 1093995672
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Entity Type | Organization
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Legal Business Name | JAVAD ABDOLLAHIAN MD, PC
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1411 HARRISON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19124-5932
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Country | US
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Telephone | 215-289-8832
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Fax | 215-289-3497
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Provider Business Mailing Address
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Address Line | 1411 HARRISON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19124-5932
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Country | US
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Telephone | 215-289-8832
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Fax | 215-289-3497
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | JAVAD ABDOLLAHIAN
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Credential |
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Telephone | 215-289-8832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD029443L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD029443L
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License Number State | PA
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