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General NPI Number Information
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NPI Number | 1659812592
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Entity Type | Individual
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Provider Name | ALFRED ABU CRNP
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Gender | Male
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Dates
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Enumeration Date | 03/11/2017
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 832 ARBOR RD
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City | YEADON
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State | PA
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Zip | 19050-3602
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Country | US
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Telephone | 610-304-2550
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Fax | 610-259-2932
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Provider Business Mailing Address
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Address Line | 1 W ELM ST STE 100
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-4108
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Country | US
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Telephone | 610-567-5408
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Fax | 610-567-6955
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP017020
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License Number State | PA
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