MEDICARE: SAFIYA LADIDI ABUBAKAR

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
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1093584948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAFIYA LADIDI ABUBAKAR

Provider Business Mailing Address
First Line	:	1617 SYCAMORE ST
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17104-2653
Country	:	US
Telephone Number	:	717-379-5302
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 S ARLINGTON AVE RM 133A
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17109-5036
Country	:	US
Telephone Number	:	717-379-5302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2023
Last Update Date	:	12/20/2023

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