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NPI Code Detail

MEDICARE: BARBARA COAXUM

MEDICARE: BARBARA COAXUM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSL-001655-LPA

General Provider Information

NPI Number : 1083746440
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARBARA COAXUM
Provider Business Mailing Address
First Line : 7051 PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19142-1724
Country : US
Telephone Number : 215-492-1223
Fax Number : 215-492-1080
Provider Business Practice Location Address
First Line : 7051 W. PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19142-1724
Country : US
Telephone Number : 215-492-1223
Fax Number : 215-492-1080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2007
Last Update Date : 07/08/2007

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Directions to “ BARBARA COAXUM ” Practice Location

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