=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104792357
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LYDIA ESKINDER TIRFE PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/15/2025
-----------------------------------------------------
Last Update Date | 10/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2701 CASTOR AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19134-5505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-305-9051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2701 CASTOR AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19134-5505
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-305-9051
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP459877
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------