Provider Demographics
NPI:1720352339
Name:MARAH, MUSA (LPN)
Entity Type:Individual
Prefix:
First Name:MUSA
Middle Name:
Last Name:MARAH
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 SERRILL AVE
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3809
Mailing Address - Country:US
Mailing Address - Phone:484-469-4692
Mailing Address - Fax:484-469-4694
Practice Address - Street 1:1027 SERRILL AVE
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3809
Practice Address - Country:US
Practice Address - Phone:484-469-4692
Practice Address - Fax:484-469-4694
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN287455164W00000X, 251S00000X, 253Z00000X, 251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health