Provider Demographics
NPI:1932606985
Name:NAYKAS HEALTHCARE NP FAMILY MEDICINE
Entity Type:Organization
Organization Name:NAYKAS HEALTHCARE NP FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MUSBAU
Authorized Official - Middle Name:
Authorized Official - Last Name:KASUMU
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP, FNP-BC
Authorized Official - Phone:267-415-8382
Mailing Address - Street 1:708 W GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-1313
Mailing Address - Country:US
Mailing Address - Phone:267-415-8382
Mailing Address - Fax:267-415-8378
Practice Address - Street 1:708 W GIRARD AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19123-1313
Practice Address - Country:US
Practice Address - Phone:267-415-8382
Practice Address - Fax:267-415-8378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015902363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty