NPI 1447851779

Mammen Cherian Vaidian

Practitioner Pharmacist Trevose, PA

Practice location

Address: 3461 Horizon Blvd, Trevose, PA 19053-4967
Phone: (215) 942-7483

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence RP445190 (PA)

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Registry record

NPI: 1447851779
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Nov 2020
Record last updated: 3 Nov 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.