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NPI Code Detail

MEDICARE: AEKYUNG BAE

MEDICARE: AEKYUNG BAE
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
1183500000XPharmacist28RI03731700NJ

General Provider Information

NPI Number : 1134571946
Entity Type Code : Individual
Provider Name (Legal Business Name) : AEKYUNG BAE
Provider Business Mailing Address
First Line : 7001 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19135-1605
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7001 FRANKFORD AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19135-1605
Country : US
Telephone Number : 215-543-0715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2016
Last Update Date : 07/05/2016

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Directions to “ AEKYUNG BAE ” Practice Location

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