Provider Demographics
NPI:1659190965
Name:IMPRAIM, NAPHTALI ATO
Entity type:Individual
Prefix:DR
First Name:NAPHTALI
Middle Name:ATO
Last Name:IMPRAIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WOODBINE RD UNIT 2209
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335-2227
Mailing Address - Country:US
Mailing Address - Phone:608-960-6193
Mailing Address - Fax:
Practice Address - Street 1:300 N BRADFORD AVE
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2216
Practice Address - Country:US
Practice Address - Phone:610-696-0145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP458952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist