| Gabriel T Tatarian, Do, Llc | |
|
1015 Chestnut St Ste 918 Philadelphia PA 19107 | |
| (215) 922-1801 | |
| Not Available |
| Full Name | Gabriel T Tatarian, Do, Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1015 Chestnut St Ste 918, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Brian A Morgan (OFFICE MANAGER) |
| Authorized Official Contact | 2159221801 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gabriel T Tatarian, Do, Llc 1015 Chestnut St Ste 918 Philadelphia PA 19107-4309 Ph: (215) 922-1801 | Gabriel T Tatarian, Do, Llc 1015 Chestnut St Ste 918 Philadelphia PA 19107 Ph: (215) 922-1801 |
| NPI Number | 1184799868 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 03/13/2019 |
| Medicare PECOS PAC ID | 5890876254 |
|---|---|
| Medicare Enrollment ID | O20080111000414 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184799868 | NPI | - | NPPES |
| 01465075 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | OS008458L (Pennsylvania) | Primary |
| Provider Name | Gabriel T Tatarian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164487914 PECOS PAC ID: 5294816690 Enrollment ID: I20080111000067 |
| Provider Name | Mary Catherine Campetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215445333 PECOS PAC ID: 1456612365 Enrollment ID: I20180308002620 |
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