| Psychphilly | |
|
1511 Carpenter St Philadelphia PA 19146-2110 | |
| (215) 923-2690 | |
| (215) 923-8940 |
| Full Name | Psychphilly |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1511 Carpenter St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Tracey Jones (PRESIDENT) |
| Authorized Official Contact | 2159232690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychphilly 1511 Carpenter St Philadelphia PA 19146-2110 Ph: (215) 923-2690 | Psychphilly 1511 Carpenter St Philadelphia PA 19146-2110 Ph: (215) 923-2690 |
| NPI Number | 1376768127 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 07/07/2023 |
| Certification Date | 07/07/2023 |
| Medicare PECOS PAC ID | 2769642784 |
|---|---|
| Medicare Enrollment ID | O20120329000340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376768127 | NPI | - | NPPES |
| Provider Name | Tracey Jones |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043361355 PECOS PAC ID: 7416130372 Enrollment ID: I20110330000688 |
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