Nasrallah, Ilya M
Nasrallah, Ilya M is an individual health care provider with primary practice located at 3400 Spruce Street , Philadelphia PA 19104-4206. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Neuroradiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Nasrallah, Ilya M can be contacted via phone (215) 615-8054.Contact Information
Primary practice address
3400 Spruce Street
Philadelphia PA 19104-4206
Phone: (215) 615-8054
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD439819 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | MD439819 | Pennsylvania |
Profile Details
| NPI number | 1982753885 |
|---|---|
| LBN Legal business name | Nasrallah, Ilya M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2007 |
| Last updated | Aug 19th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982753885 | NPPES |
| Pennsylvania | MEDICAID | 102472676-0001 |
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