Individual
BASSIL MAZEN KUBLAOUI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - ENDOCRINOLOGY, PHILADELPHIA, PA 19104-4319
(215) 590-3174
(215) 590-3053
Mailing address
100 E PENN SQ, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9234
(267) 425-9299
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
L4024
TX
2080P0205X
Pediatric Endocrinology Physician
Primary
MD438428
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149928710
—
TX
Enumeration date
03/27/2006
Last updated
04/15/2013
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