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General NPI Number Information
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NPI Number | 1205491602
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Entity Type | Individual
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Provider Name | SALIYA GAFAROV
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Gender | Female
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Dates
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Enumeration Date | 05/01/2019
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 3525 COTTMAN AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19149-1607
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Country | US
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Telephone | 675-365-0852
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Fax | 215-439-7977
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Provider Business Mailing Address
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Address Line | 108 HILLTOP DR
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City | CHURCHVILLE
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State | PA
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Zip | 18966-1370
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Country | US
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Telephone | 717-747-4346
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RP452512
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP452512
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License Number State | PA
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