=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841176179
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GHADA MASSAD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2025
-----------------------------------------------------
Last Update Date | 08/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3295 ROUTE 100
-----------------------------------------------------
City | MACUNGIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18062-9611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-967-5684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3295 ROUTE 100
-----------------------------------------------------
City | MACUNGIE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18062-9611
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-967-5684
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | RP459333
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------