Provider Demographics
NPI:1528449659
Name:NAWAZ, RAWAN (DC)
Entity type:Individual
Prefix:DR
First Name:RAWAN
Middle Name:
Last Name:NAWAZ
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 NEWTON LAKE DR APT D310
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-1626
Mailing Address - Country:US
Mailing Address - Phone:215-309-2380
Mailing Address - Fax:
Practice Address - Street 1:1528 WALNUT ST STE 1402
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-3610
Practice Address - Country:US
Practice Address - Phone:215-309-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAJ010802111N00000X
PADC011030111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor