Provider Demographics
NPI:1356920854
Name:NEAL-BEYAH, LUCRETIA (HOMECARE OWNER)
Entity type:Individual
Prefix:
First Name:LUCRETIA
Middle Name:
Last Name:NEAL-BEYAH
Suffix:
Gender:F
Credentials:HOMECARE OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5941 WOODBINE AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19131-1206
Mailing Address - Country:US
Mailing Address - Phone:267-253-4011
Mailing Address - Fax:
Practice Address - Street 1:5723 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19131-4135
Practice Address - Country:US
Practice Address - Phone:215-420-2655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-03
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide