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General NPI Number Information
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NPI Number | 1144943614
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Entity Type | Individual
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Provider Name | JWALA ALEX PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/20/2022
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Last Update Date | 09/20/2022
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Provider Practice Location Address
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Address Line | 306 E BALTIMORE AVE
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City | MEDIA
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State | PA
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Zip | 19063-3807
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Country | US
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Telephone | 610-566-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 61 DELAFIELD PL
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City | STATEN ISLAND
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State | NY
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Zip | 10310-1675
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Country | US
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Telephone | 347-486-8422
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP455859
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License Number State | PA
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