Individual
FATJON MADANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 FRANKLIN TOWN BLVD APT 210, PHILADELPHIA, PA 19103-1241
(445) 444-0747
Mailing address
5501 OLD YORK RD STE 1, PHILADELPHIA, PA 19141-3098
(215) 456-7890
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
0066483
PA
Other
Enumeration date
05/01/2020
Last updated
05/01/2020
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