Individual
BENJAMIN THIVARATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4133 G ST, PHILADELPHIA, PA 19124-5117
(215) 831-9304
Mailing address
5837 N LAWRENCE ST, PHILADELPHIA, PA 19120-1859
(267) 237-2644
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP452501
PA
Other
Enumeration date
12/01/2020
Last updated
12/01/2020
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