| |
333 Bainbridge St, 1st Floor, Philadelphia, PA 19147-1542 | |
(215) 922-6333 | |
(215) 922-6310 |
Full Name | |
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Type | Facility |
Speciality | Chiropractor |
Location | 333 Bainbridge St, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356494793 | NPI | - | NPPES |
0167580000 | Other | PA | PERSONAL CHOICE |
01561895 | Medicaid | PA | |
0167580000 | Other | PA | KEYSTONE HEALTH PLAN EAST |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | DC006178L (Pennsylvania) | Primary |
Provider Name | Ralph J Demarino |
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Provider Type | Practitioner - Chiropractic |
Provider Identifiers | NPI Number: 1720184245 PECOS PAC ID: 2163505884 Enrollment ID: I20080218000640 |
Mailing Address | Practice Location Address |
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333 Bainbridge St, 1st Floor, Philadelphia, PA 19147-1542 Ph: (215) 922-6333 | 333 Bainbridge St, 1st Floor, Philadelphia, PA 19147-1542 Ph: (215) 922-6333 |
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