| The Consortium Inc. | |
|
2020 Pennsylvania Ave Philadelphia PA 19130-3832 | |
| (215) 596-8100 | |
| (215) 382-4405 |
| Full Name | The Consortium Inc. |
|---|---|
| Speciality | Psychoanalyst |
| Location | 2020 Pennsylvania Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John F White (PRESIDENT /CFO) |
| Authorized Official Contact | 2155968100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Consortium Inc. 3801 Market Street 201 Philadelphia PA 19104-3153 Ph: (215) 596-8100 | The Consortium Inc. 2020 Pennsylvania Ave Philadelphia PA 19130-3832 Ph: (215) 596-8100 |
| NPI Number | 1689837296 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 07/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689837296 | NPI | - | NPPES |
| 1007155230076 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 102L00000X | Psychoanalyst | (* (Not Available)) | Primary |
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