Provider Demographics
NPI:1720700545
Name:BANI, ELENA (RPH)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:BANI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6501 HARBISON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19149-2912
Mailing Address - Country:US
Mailing Address - Phone:215-333-4300
Mailing Address - Fax:
Practice Address - Street 1:6542 LOGAN SQ
Practice Address - Street 2:
Practice Address - City:NEW HOPE
Practice Address - State:PA
Practice Address - Zip Code:18938-1811
Practice Address - Country:US
Practice Address - Phone:215-862-9065
Practice Address - Fax:215-862-9064
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2023-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP456087183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist