Most Relevant Information
Provider Data
| NPI Number: | 1003201617 |
| Provider Name: | NICHOLAS KIAN MOLLANAZAR MD, MBA |
| Entity Type: | Individual |
| Taxonomy Code: | 207N00000X |
| Specialty: | Dermatology |
| License Number: | MD467873 |
Most Important Dates
| Enumeration Date: | 03/31/2015 |
| Last Updated: | 08/05/2019 |
Provider Practice Location
3400 SPRUCE ST
2 MALONEY BUILDING
PHILADELPHIA
PA
19104
Practice Location Phone/Fax
| Phone: | 2156627366 |
| Fax: |
Provider Mailing Location
3400 SPRUCE ST
2 MALONEY BUILDING
PHILADELPHIA
PA
19104
Provider Mailing Phone/Fax
| Phone: | 2156627366 |
| Fax: |