Whalio Doctors

NPI 1053907261

Pearl a Lake

Practitioner Military Health Care Provider Philadelphia, PA

Practice location

Address
2214 S 57th St, Philadelphia, PA 19143-5705
Phone
(886) 884-8807
Fax
(215) 825-5161
Mailing address
2250 E Monmouth St, Philadelphia, PA 19134-4103

Registered specialties (2)

Military Health Care Provider Primary
Other Service Providers Taxonomy 171000000X Licence 7000.000000634RMA (PA)
Military Health Care Provider
Other Service Providers Taxonomy 171000000X Licence 70000634RMA (PA)

Registry record

NPI
1053907261
Entity type
Individual
Sex (as registered)
Female
NPI issued
12 Dec 2020
Record last updated
12 Dec 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.