Basic Information
Provider Information
NPI: 1639599764
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ABELARD-DANIEL
FirstName: ARLENE
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6024 AVONHOE RD
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191381502
CountryCode: US
TelephoneNumber: 2159671177
FaxNumber:  
Practice Location
Address1: 3401 CIVIC CENTER BLVD
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191044319
CountryCode: US
TelephoneNumber: 2155901000
FaxNumber: 2155901000
Other Information
ProviderEnumerationDate: 04/16/2014
LastUpdateDate: 03/17/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LP0200XSP013640PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics

No ID Information.


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