Provider Demographics
NPI:1396191490
Name:KALOKO, ABU
Entity Type:Individual
Prefix:
First Name:ABU
Middle Name:
Last Name:KALOKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7248 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19142-1533
Mailing Address - Country:US
Mailing Address - Phone:267-292-2876
Mailing Address - Fax:267-292-2936
Practice Address - Street 1:7248 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19142-1533
Practice Address - Country:US
Practice Address - Phone:267-292-2876
Practice Address - Fax:267-292-2936
Is Sole Proprietor?:No
Enumeration Date:2016-05-06
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN282473164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse