MEDICARE: MRS. PATRICIA RUTH AHADYAR MSW

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	SW000889E	PA

General Provider Information

NPI Number	:	1992939847
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. PATRICIA RUTH AHADYAR MSW

Provider Business Mailing Address
First Line	:	1400 REED ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-4823
Country	:	US
Telephone Number	:	215-755-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 REED ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-4823
Country	:	US
Telephone Number	:	215-755-0500
Fax Number	:

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

Provider Enumeration Date	:	05/06/2009
Last Update Date	:	05/06/2009

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