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General NPI Number Information
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NPI Number | 1861648321
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Entity Type | Individual
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Provider Name | JALEH SHAHRIARI
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Gender | Female
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Dates
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Enumeration Date | 08/14/2008
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Last Update Date | 08/14/2008
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Provider Practice Location Address
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Address Line | 8850 FRANKFORD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19136-1313
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Country | US
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Telephone | 215-624-4061
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Fax |
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Provider Business Mailing Address
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Address Line | 697 BOBWHITE LN
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City | HUNTINGDON VALLEY
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State | PA
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Zip | 19006-2117
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Country | US
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Telephone | 215-947-5975
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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 | RP039196L
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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 | 28RI02236700
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License Number State | NJ
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