MEDICARE: LAILA FAKRI

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	1041C0700X	Clinical Social Worker	26253	MD
2	1041C0700X	Clinical Social Worker	CW023718	PA

General Provider Information

NPI Number	:	1497356265
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAILA FAKRI

Provider Business Mailing Address
First Line	:	1833 S 6TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1732
Country	:	US
Telephone Number	:	202-670-4057
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 S 6TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19148-1732
Country	:	US
Telephone Number	:	202-670-4057
Fax Number	:

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

Provider Enumeration Date	:	11/06/2020
Last Update Date	:	05/27/2026

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Directions to “ LAILA FAKRI ” Practice Location

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