Individual
CHARLOTTE FATOMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 W SELLERS AVE, RIDLEY PARK, PA 19078-1123
(267) 888-1688
Mailing address
307 W SELLERS AVE, RIDLEY PARK, PA 19078-1123
(267) 888-1688
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
10064043
PA
Other
Enumeration date
10/06/2022
Last updated
10/06/2022
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