Provider Demographics
NPI:1780142869
Name:KADOR, HOMAM
Entity type:Individual
Prefix:
First Name:HOMAM
Middle Name:
Last Name:KADOR
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 1:107 LILLY ST APT 2
Mailing Address - Street 2:
Mailing Address - City:SCHUYLKILL HAVEN
Mailing Address - State:PA
Mailing Address - Zip Code:17972-1156
Mailing Address - Country:US
Mailing Address - Phone:313-375-9262
Mailing Address - Fax:
Practice Address - Street 1:15 WEST MAHANOY CITY
Practice Address - Street 2:
Practice Address - City:MAHANOY
Practice Address - State:PA
Practice Address - Zip Code:17973
Practice Address - Country:US
Practice Address - Phone:579-012-3542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-07
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP453052183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty