Provider Demographics
NPI:1538539713
Name:ELHADI, FAJR KHALIFAH (MS)
Entity type:Individual
Prefix:MRS
First Name:FAJR
Middle Name:KHALIFAH
Last Name:ELHADI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 PARKVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:YEADON
Mailing Address - State:PA
Mailing Address - Zip Code:19050-3433
Mailing Address - Country:US
Mailing Address - Phone:215-900-6370
Mailing Address - Fax:
Practice Address - Street 1:651 PARKVIEW BLVD
Practice Address - Street 2:
Practice Address - City:YEADON
Practice Address - State:PA
Practice Address - Zip Code:19050-3433
Practice Address - Country:US
Practice Address - Phone:215-900-6370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-01
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABB000688103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst