Individual
MR. FRED KYEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6908 ANDERSON ST, PHILADELPHIA, PA 19119-1312
(215) 248-0495
(215) 247-0549
Mailing address
6908 ANDERSON ST, PHILADELPHIA, PA 19119-1312
(215) 248-0495
(215) 247-0549
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
27143601
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103027305002
—
PA
Enumeration date
12/27/2018
Last updated
12/27/2018
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