Provider Demographics
NPI:1508666561
Name:DARAMY, FATMATA L
Entity type:Individual
Prefix:
First Name:FATMATA
Middle Name:L
Last Name:DARAMY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:FATMATA
Other - Middle Name:L
Other - Last Name:BAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:111 HILLDALE RD
Mailing Address - Street 2:
Mailing Address - City:LANSDOWNE
Mailing Address - State:PA
Mailing Address - Zip Code:19050-2347
Mailing Address - Country:US
Mailing Address - Phone:610-800-3491
Mailing Address - Fax:
Practice Address - Street 1:18 CAMPUS BLVD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3245
Practice Address - Country:US
Practice Address - Phone:610-803-4918
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP031703363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health