Provider Demographics
NPI:1992528095
Name:JOHNY, LENA VALSA
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:VALSA
Last Name:JOHNY
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 1:126 GWYNEDD LEA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH WALES
Mailing Address - State:PA
Mailing Address - Zip Code:19454-1922
Mailing Address - Country:US
Mailing Address - Phone:215-882-2490
Mailing Address - Fax:
Practice Address - Street 1:2501 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19132-3207
Practice Address - Country:US
Practice Address - Phone:215-227-0300
Practice Address - Fax:215-227-0302
Is Sole Proprietor?:No
Enumeration Date:2024-11-06
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029298363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology