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NPI Code Detail

MEDICARE: SEAN BAE

MEDICARE: SEAN 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
1183500000XPharmacistRP446032PA

General Provider Information

NPI Number : 1467867408
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN BAE
Provider Business Mailing Address
First Line : 228 HARLEY CT
Second Line :
City : NORTH WALES
State : PA
Zip : 19454-1613
Country : US
Telephone Number : 213-379-0365
Fax Number :
Provider Business Practice Location Address
First Line : 2545 ARAMINGO AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19125-3728
Country : US
Telephone Number : 215-423-2361
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2014
Last Update Date : 06/28/2014

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Directions to “ SEAN BAE ” Practice Location

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