Individual
IBRAHIM T BEIDARI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
111 S FRONT ST, HARRISBURG, PA 17101-2010
(717) 782-3380
(717) 782-5716
Mailing address
409 S 2ND ST STE 2F, HARRISBURG, PA 17104-1612
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP016119
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103112700
—
PA
Enumeration date
05/11/2016
Last updated
01/23/2018
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