Individual
MS. NIYA EVELYN HARGREAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-7220
Mailing address
2301 S BROAD ST, PHILADELPHIA, PA 19148-3542
(215) 952-7220
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA003065-L
PA
Other
Enumeration date
06/04/2008
Last updated
06/04/2008
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