Organization
FADEMOS FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIAM SALAHOU CRNP (CEO/CLINICAL DIRECTOR)
(215) 613-5069
Entity
Organization
Contact information
Practice address
16 OLD ASHTON RD STE 1, PHILADELPHIA, PA 19152-1661
(215) 613-5069
(215) 613-6809
Mailing address
16 OLD ASHTON RD STE 1, PHILADELPHIA, PA 19152-1661
(215) 613-5069
(215) 613-6809
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
SP008704
PA
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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