Individual
BEENISH ASHFAQ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
52 COUNTRY LANE DR, PHILADELPHIA, PA 19115-2183
(484) 860-6746
Mailing address
52 COUNTRY LANE DR, PHILADELPHIA, PA 19115-2183
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA063486
PA
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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