Organization
AHASHTA JOHNSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
A. SUSAN BERNINI (COO)
(215) 456-7890
Entity
Organization
Contact information
Practice address
5501 OLD YORK RD, PHILA, PA 19141-3018
(215) 456-7890
Mailing address
6701 N 7TH ST, PHILADELPHIA, PA 19126-3024
(267) 235-2696
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MT185979
PA
Other
Enumeration date
05/08/2007
Last updated
04/10/2009
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