Provider Demographics
NPI:1336651017
Name:AFIF, RADHIA (LBSC)
Entity Type:Individual
Prefix:
First Name:RADHIA
Middle Name:
Last Name:AFIF
Suffix:
Gender:F
Credentials:LBSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5943 WEYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-1122
Mailing Address - Country:US
Mailing Address - Phone:215-203-4003
Mailing Address - Fax:
Practice Address - Street 1:5943 WEYMOUTH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-1122
Practice Address - Country:US
Practice Address - Phone:215-203-4003
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH003318174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty