Individual
ISHMAIL A THOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1027 SERRILL AVE, YEADON, PA 19050-3809
(484) 469-4692
(484) 469-4694
Mailing address
1027 SERRILL AVE, YEADON, PA 19050-3809
(484) 469-4692
(484) 469-4694
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN282050
PA
251E00000X
Home Health Agency
PN282050
PA
251J00000X
Nursing Care Agency
PN282050
PA
251S00000X
Community/Behavioral Health Agency
PN282050
PA
253Z00000X
In Home Supportive Care Agency
PN282050
PA
Other
Enumeration date
02/28/2012
Last updated
02/29/2012
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