MEDICARE: MS. ALYSIA AMREEN MAKHANI CPNP

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	363LP0200X	Pediatric Nurse Practitioner	SP021596	PA

General Provider Information

NPI Number	:	1841421708
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALYSIA AMREEN MAKHANI CPNP

Provider Business Mailing Address
First Line	:	100 W OXFORD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-3927
Country	:	US
Telephone Number	:	562-276-5897
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 W OXFORD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19122-3927
Country	:	US
Telephone Number	:	484-442-0507
Fax Number	:

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

Provider Enumeration Date	:	07/27/2009
Last Update Date	:	02/28/2020

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