Individual
HABIBATU SAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7248 ELMWOOD AVE, PHILADELPHIA, PA 19142-1533
(215) 531-4178
(267) 292-2936
Mailing address
7248 ELMWOOD AVE, PHILADELPHIA, PA 19142-1533
(215) 531-4178
(267) 292-2936
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN283356
PA
Other
Enumeration date
07/12/2018
Last updated
07/12/2018
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