Individual
FRED UTKIROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1901 W OREGON AVE, PHILADELPHIA, PA 19145-4200
(215) 551-8265
Mailing address
1901 W OREGON AVE, PHILADELPHIA, PA 19145-4200
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP459306
PA
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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