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Individual

MASSIEL N OVALLES PERDOMO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
403 ALCOTT ST, PHILADELPHIA, PA 19120-1101
(267) 516-6829
Mailing address
403 ALCOTT ST, PHILADELPHIA, PA 19120-1101
(267) 516-6829

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
88853601
PA
374U00000X
Home Health Aide
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1124994348
PA
Enumeration date
12/08/2025
Last updated
02/05/2026
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