ARDI HERMAWAN

PHILADELPHIA, PA
NPI1891267753
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP2300X Nurse Practitioner Primary Care
(Licence: PA  SP019639)
Enumeration Date2018-12-17
Last Update Date2020-06-11
Business Address
ARDI HERMAWAN NP-C
2101 W LEHIGH AVE STE A
PHILADELPHIA, PA 19132-2664
Phone number: 267-866-7211
Mailing Address
ARDI HERMAWAN NP-C
1395 NW 167TH ST
MIAMI GARDENS, FL 33169-5710
Phone number: 267-866-7211
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