Individual
AYATE KACED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
911 N 15TH ST, PHILADELPHIA, PA 19130-1781
(856) 974-0874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063127
PA
Other
Enumeration date
11/05/2021
Last updated
11/08/2021
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