MEDICARE: MUNIYRA MUHAMMAD NCC

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	101YP2500X	Professional Counselor	1728057	PA

General Provider Information

NPI Number	:	1710759634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUNIYRA MUHAMMAD NCC

Provider Business Mailing Address
First Line	:	2204 W VENANGO ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-3823
Country	:	US
Telephone Number	:	215-400-0720
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 W VENANGO ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19140-3823
Country	:	US
Telephone Number	:	215-400-0720
Fax Number	:

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

Provider Enumeration Date	:	10/24/2023
Last Update Date	:	10/24/2023

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