Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 25MA11165900 | NJ |
Y | 207K00000X | Allergist & Immunologist | MD469878 | PA |
NPI | 1104176106 |
---|---|
Provider Name | Elias Akl |
First Address | Philadelphia, PA 19103-5451 |
Second Address | Philadelphia, PA 19103-5451 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2012 |
Last Update Date | 27/08/2021 |