Provider Demographics
NPI:1831978550
Name:SALOM, ANNA SABEIH (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:SABEIH
Last Name:SALOM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ENTIDHAR
Other - Middle Name:ABDULRAHEEM
Other - Last Name:SADEQ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:9501 ROOSEVELT BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1029
Mailing Address - Country:US
Mailing Address - Phone:215-969-9511
Mailing Address - Fax:
Practice Address - Street 1:9501 ROOSEVELT BLVD APT SUITE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1025
Practice Address - Country:US
Practice Address - Phone:215-969-9511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028275363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology