| Joshua Balogun Medical Center | |
|
5044 Spruce Street Philadelphia PA 19139-4148 | |
| (215) 474-4410 | |
| Not Available |
| Full Name | Joshua Balogun Medical Center |
|---|---|
| Speciality | Psychologist - Clinical Child & Adolescent |
| Location | 5044 Spruce Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Henry Israel Balogun (CHAIRMAN/CEO) |
| Authorized Official Contact | 2157048223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Joshua Balogun Medical Center 5044 Spruce Street Philadelphia PA 19139-4148 Ph: (215) 474-4410 | Joshua Balogun Medical Center 5044 Spruce Street Philadelphia PA 19139-4148 Ph: (215) 474-4410 |
| NPI Number | 1588836118 |
|---|---|
| Provider Enumeration Date | 03/24/2008 |
| Last Update Date | 01/25/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588836118 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Primary |
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