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General NPI Number Information
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NPI Number | 1932131950
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Entity Type | Individual
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Provider Name | VIRGINIA FONASH SAMHOURI CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2137 WELSH RD SUITE 1-C
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City | PHILADELPHIA
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State | PA
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Zip | 19115-4963
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Country | US
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Telephone | 215-969-3944
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Fax | 215-969-3886
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Provider Business Mailing Address
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Address Line | 1394 TANGLEWOOD DR
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City | NORTH WALES
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State | PA
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Zip | 19454-3677
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Country | US
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Telephone | 215-699-8199
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | UP006861H
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License Number State | PA
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