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Individual

MRS. INESSA G. BINIAURISHVILI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
11685-C BUSTLETON AVE., PHILADELPHIA, PA 19116-2542
(215) 464-7820
(215) 464-7808
Mailing address
11685-C BUSTLETON AVE., PHILADELPHIA, PA 19116-2542
(215) 464-7820
(215) 464-7808

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD061863-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0016575930004
PA
Enumeration date
10/02/2006
Last updated
02/16/2010
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