MRS. PEARL A LAKE NPI 1053907261

NPI Information

MRS. Pearl A Lake is a military health care provider in Philadelphia, PA. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. MRS. Pearl A Lake NPI is 1053907261. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2214 S 57TH ST
PHILADELPHIA, PA
ZIP 19143-705
Phone: (886) 884-8807
Fax: (215) 825-5161

The enumeration date for this NPI number is 12/12/2020 and was last updated on 12/12/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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