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General NPI Number Information
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NPI Number | 1194844001
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Entity Type | Individual
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Provider Name | GUL MADISON
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Gender | Female
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Dates
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Enumeration Date | 03/29/2007
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 9501 ROOSEVELT BLVD SUITE 208
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1025
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Country | US
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Telephone | 215-464-9634
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Fax |
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Provider Business Mailing Address
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Address Line | 9501 ROOSEVELT BLVD SUITE 208
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1025
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Country | US
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Telephone |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | MD436900
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License Number State | PA
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