MEDICARE: DR. NEKEISHA ALEXANDER ABDUL-HAKIM DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	SC006270	PA
2	213E00000X	Podiatrist	SC006270	PA
3	213EP1101X	Primary Podiatric Medicine Podiatrist	SC006270	PA

General Provider Information

NPI Number	:	1649568056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEKEISHA ALEXANDER ABDUL-HAKIM DPM

Provider Business Mailing Address
First Line	:	805 E WILLOW GROVE AVE STE 1B
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-7968
Country	:	US
Telephone Number	:	215-844-0308
Fax Number	:	215-844-0370

Provider Business Practice Location Address
First Line	:	805 E WILLOW GROVE AVE STE 1B
Second Line	:
City	:	GLENSIDE
State	:	PA
Zip	:	19038-7968
Country	:	US
Telephone Number	:	215-844-0308
Fax Number	:	215-844-0370

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

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	01/02/2024

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