| 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: Medicare Enrolled Practice Location: 2415 Franklin Ave, Secane, PA 19018 Phone: 267-230-8854 |