Provider Demographics
NPI:1437435377
Name:WAH, LAILA (OMD)
Entity type:Individual
Prefix:
First Name:LAILA
Middle Name:
Last Name:WAH
Suffix:
Gender:F
Credentials:OMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 123
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-0123
Mailing Address - Country:US
Mailing Address - Phone:215-808-8919
Mailing Address - Fax:215-808-8919
Practice Address - Street 1:530 S 2ND ST
Practice Address - Street 2:SUITE 106
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-2420
Practice Address - Country:US
Practice Address - Phone:215-808-8919
Practice Address - Fax:215-808-8919
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath