Ansu Siryon Molley, | |
649 South Ave Unit 7, Secane, PA 19018-3541 | |
(610) 944-4290 | |
Not Available |
Full Name | Ansu Siryon Molley |
---|---|
Gender | Male |
Speciality | Nurse Practitioner - Family |
Location | 649 South Ave Unit 7, Secane, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1891228987 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | SP017298 (Pennsylvania) | Primary |
Entity Name | Molley Family Healthcare & Wellness Center Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356104541 PECOS PAC ID: 9739520099 Enrollment ID: O20240517000233 |
Mailing Address | Practice Location Address |
---|---|
Ansu Siryon Molley, 649 South Ave Unit 7, Secane, PA 19018-3541 Ph: (610) 944-4290 | Ansu Siryon Molley, 649 South Ave Unit 7, Secane, PA 19018-3541 Ph: (610) 944-4290 |
Ms. Shakeelah Patterson, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1019 Lamb Rd, Secane, PA 19018 Phone: 267-575-3956 | |
Fanny Mimi Dougan, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2525 Secane Rd, Secane, PA 19018 Phone: 484-472-3901 | |
Fatima Gayle, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2415 Franklin Ave, Secane, PA 19018 Phone: 267-230-8854 |