Provider Demographics
NPI:1457459232
Name:TALAAT, ETEMAD ABD ELRAOF (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ETEMAD
Middle Name:ABD ELRAOF
Last Name:TALAAT
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NETHERFIELD LN
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:610-918-8276
Mailing Address - Fax:610-918-8276
Practice Address - Street 1:1400 BLACK HORSE HILL RD #119
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-383-0282
Practice Address - Fax:610-383-0269
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24871183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist