Individual
MARIAM SALAHOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
16 OLD ASHTON RD, SUITE 1, PHILA, PA 19152-1661
(215) 613-5069
(215) 613-6809
Mailing address
16 OLD ASHTON RD, SUITE 1, PHILA, PA 19152-1661
(215) 613-5069
(215) 613-6809
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
SP008704
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11585583
CAQH
PA
01
—
1487927
AETNA
PA
01
—
17574
BRAVO (ELDER) HEALTH
PA
01
—
2848495000
IBC
PA
01
—
30013868
KEYSTONE MERCY HEALTH PLN
PA
Enumeration date
07/28/2006
Last updated
05/16/2015
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