Individual
IDA MICAILY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
925 CHESTNUT ST FL 3, PHILADELPHIA, PA 19107-4216
(215) 955-8874
Mailing address
1200 OLD YORK RD, ABINGTON, PA 19001-3720
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT211696
PA
207RH0003X
Hematology & Oncology Physician
Primary
MD468727
PA
Other
Enumeration date
06/02/2016
Last updated
03/09/2023
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