Individual
CHARLI DRIALO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3376
(215) 707-4058
Mailing address
3500 N BROAD ST, PHILADELPHIA, PA 19140-4106
(215) 707-2433
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA065917
PA
Other
Enumeration date
09/30/2024
Last updated
10/28/2024
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