Provider Demographics
NPI:1124848023
Name:MDAHI, FALAK
Entity type:Individual
Prefix:
First Name:FALAK
Middle Name:
Last Name:MDAHI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3413 ASH WAY
Mailing Address - Street 2:
Mailing Address - City:PERKIOMENVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18074-9430
Mailing Address - Country:US
Mailing Address - Phone:610-585-3318
Mailing Address - Fax:
Practice Address - Street 1:173 HOLLY RD
Practice Address - Street 2:
Practice Address - City:GILBERTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19525-9367
Practice Address - Country:US
Practice Address - Phone:610-473-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP459019183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist