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General NPI Number Information
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NPI Number | 1932606985
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Entity Type | Organization
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Legal Business Name | NAYKAS HEALTHCARE NP FAMILY MEDICINE
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 708 W GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19123-1313
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Country | US
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Telephone | 267-415-8382
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Fax | 267-415-8378
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Provider Business Mailing Address
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Address Line | 708 W GIRARD AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19123-1313
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Country | US
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Telephone | 267-415-8382
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Fax | 267-415-8378
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Authorized Official
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Title or Position | COO
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Name | MUSBAU KASUMU
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Credential | CRNP, FNP-BC
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Telephone | 267-415-8382
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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 | SP015902
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License Number State | PA
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