Provider Demographics
NPI:1770016677
Name:AFRA WOUND CARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:AFRA WOUND CARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KWASI
Authorized Official - Middle Name:
Authorized Official - Last Name:MANU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-630-5088
Mailing Address - Street 1:1717 COUNTRY CLUB DR
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3448
Mailing Address - Country:US
Mailing Address - Phone:617-686-3726
Mailing Address - Fax:856-428-2706
Practice Address - Street 1:773 SUMNEYTOWN PIKE
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5301
Practice Address - Country:US
Practice Address - Phone:856-866-6944
Practice Address - Fax:856-243-5314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-06
Last Update Date:2019-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD440751208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty