Provider Demographics
NPI:1477966406
Name:KHALIL, NERMINE
Entity Type:Individual
Prefix:
First Name:NERMINE
Middle Name:
Last Name:KHALIL
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 1:2601 PENNSYLVANIA AVE
Mailing Address - Street 2:APT 309
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-2314
Mailing Address - Country:US
Mailing Address - Phone:215-715-0794
Mailing Address - Fax:
Practice Address - Street 1:2601 PENNSYLVANIA AVE
Practice Address - Street 2:APT 309
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-2314
Practice Address - Country:US
Practice Address - Phone:215-715-0794
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP445044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist