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NPI Code Detail

MEDICARE: IBRAHIM IBRAHIM DC

MEDICARE: IBRAHIM IBRAHIM DC
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
1111N00000XChiropractorDC 007986-LPA

General Provider Information

NPI Number : 1346259413
Entity Type Code : Individual
Provider Name (Legal Business Name) : IBRAHIM IBRAHIM DC
Provider Business Mailing Address
First Line : 2757 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-1727
Country : US
Telephone Number : 215-225-7330
Fax Number :
Provider Business Practice Location Address
First Line : 2757 GERMANTOWN AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19133-1727
Country : US
Telephone Number : 215-225-7330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2006
Last Update Date : 07/08/2007

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Directions to “ IBRAHIM IBRAHIM DC” Practice Location

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