Provider Demographics
NPI:1295328227
Name:ALIJAFARI, MAYSA
Entity type:Individual
Prefix:
First Name:MAYSA
Middle Name:
Last Name:ALIJAFARI
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 1:24 E MOUNT PLEASANT AVE SIDE 3
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1888
Mailing Address - Country:US
Mailing Address - Phone:610-739-9397
Mailing Address - Fax:
Practice Address - Street 1:500 OFFICE CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-3234
Practice Address - Country:US
Practice Address - Phone:215-540-2150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-20
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health