Sultana Abdur Raheem

Individual provider Active NPI Speech-Language Pathologist · Philadelphia, PA

NPI 1093532087 · NPPES record last updated Sep 23, 2024

Key facts

NPI
1093532087
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SL017760 (PA)
Practice address
Bayard Taylor Elementary School
3698 North Randolph Street
Philadelphia, PA 19140
Phone
(215) 400-3880
NPI assigned
Sep 23, 2024
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SL017760PAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SL017760 PA Yes

Addresses

Primary practice location

Bayard Taylor Elementary School
3698 North Randolph Street
Philadelphia, PA 19140

Mailing address

Bayard Taylor School
3698 North Randolph Street
Philadelphia, PA 19140
Phone (215) 400-3880

Other providers in Philadelphia, PA

All providers in Philadelphia, PA · Speech-Language Pathologist in Pennsylvania

Sources for this page

Verify at the official NPI Registry.