Greater Philadelphia Asian Social Service Center | |
4943 N 5th St Philadelphia PA 19120-3809 | |
(215) 456-1662 | |
(215) 456-1664 |
Full Name | Greater Philadelphia Asian Social Service Center |
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Speciality | Community/Behavioral Health |
Location | 4943 N 5th St, Philadelphia, Pennsylvania |
Authorized Official Name and Position | Eunyoun Kim (PROJECT DIRECTOR) |
Authorized Official Contact | 2154561662 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Greater Philadelphia Asian Social Service Center 4943 N 5th St Philadelphia PA 19120-3809 Ph: (215) 456-1662 | Greater Philadelphia Asian Social Service Center 4943 N 5th St Philadelphia PA 19120-3809 Ph: (215) 456-1662 |
NPI Number | 1497914923 |
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Provider Enumeration Date | 06/09/2008 |
Last Update Date | 06/09/2008 |
Medicare PECOS PAC ID | 1951737535 |
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Medicare Enrollment ID | O20200129002151 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497914923 | NPI | - | NPPES |
100730234 0003 | Medicaid | PA | |
100730234 0002 | Medicaid | PA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 807367 (Pennsylvania) | Primary |
Provider Name | Ron David Mahlab |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1053452755 PECOS PAC ID: 3779514724 Enrollment ID: I20050830000106 |
Provider Name | Linell Baylis |
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Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1306810767 PECOS PAC ID: 6507864303 Enrollment ID: I20061109000466 |
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