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NPI Code Detail

MEDICARE: DR. ASRES D LAFEBO

MEDICARE: DR. ASRES D LAFEBO
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
1183500000XPharmacistRP456481PA

General Provider Information

NPI Number : 1710647953
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASRES D LAFEBO
Provider Business Mailing Address
First Line : 338 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-2321
Country : US
Telephone Number : 215-634-4397
Fax Number :
Provider Business Practice Location Address
First Line : 338 E ALLEGHENY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19134-2321
Country : US
Telephone Number : 215-634-4397
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2021
Last Update Date : 12/29/2021

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Directions to “ DR. ASRES D LAFEBO ” Practice Location

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