Provider Demographics
NPI:1235944166
Name:AKHAVAN, CRISTINA FATIMA
Entity type:Individual
Prefix:
First Name:CRISTINA
Middle Name:FATIMA
Last Name:AKHAVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 TOLL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:PA
Mailing Address - Zip Code:18966
Mailing Address - Country:US
Mailing Address - Phone:267-983-4706
Mailing Address - Fax:267-458-0127
Practice Address - Street 1:196 W ASHLAND ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-4040
Practice Address - Country:US
Practice Address - Phone:267-983-4706
Practice Address - Fax:267-458-0127
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No374U00000XNursing Service Related ProvidersHome Health Aide