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NPI Code Detail

MEDICARE: BASHERA ABDUL-HADI PA-C

MEDICARE: BASHERA ABDUL-HADI PA-C
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
1363AM0700XMedical Physician AssistantMA002355LPA

General Provider Information

NPI Number : 1174570329
Entity Type Code : Individual
Provider Name (Legal Business Name) : BASHERA ABDUL-HADI PA-C
Provider Business Mailing Address
First Line : 2501 W LEHIGH AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19132-3207
Country : US
Telephone Number : 215-227-0300
Fax Number : 215-227-0302
Provider Business Practice Location Address
First Line : 2501 W LEHIGH AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19132-3207
Country : US
Telephone Number : 215-227-0300
Fax Number : 215-227-0302
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2006
Last Update Date : 07/08/2007

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Directions to “ BASHERA ABDUL-HADI PA-C” Practice Location

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