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General NPI Number Information
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NPI Number | 1679179600
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Entity Type | Individual
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Provider Name | NICOLE TAUBER
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Gender | Female
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Dates
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Enumeration Date | 12/06/2020
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Last Update Date | 12/06/2020
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Provider Practice Location Address
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Address Line | 835 OLD YORK RD
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City | JENKINTOWN
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State | PA
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Zip | 19046-1601
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Country | US
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Telephone | 215-886-2923
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Fax |
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Provider Business Mailing Address
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Address Line | 1037 BALMORAL WAY
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City | MAPLE GLEN
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State | PA
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Zip | 19002-1623
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Country | US
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Telephone | 215-646-1806
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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 | RP039810L
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License Number State | PA
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