| Vitae Health Medical Pennsylvania Llc | |
|
7800 Bustleton Ave Philadelphia PA 19152-3812 | |
| (215) 722-2300 | |
| Not Available |
| Full Name | Vitae Health Medical Pennsylvania Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7800 Bustleton Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Amish Patel (PRESIDENT) |
| Authorized Official Contact | 8338482347 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Health Medical Pennsylvania Llc 415 W Golf Rd Ste 26 Arlington Heights IL 60005-3923 Ph: (833) 848-2347 | Vitae Health Medical Pennsylvania Llc 7800 Bustleton Ave Philadelphia PA 19152-3812 Ph: (215) 722-2300 |
| NPI Number | 1548922438 |
|---|---|
| Provider Enumeration Date | 10/08/2021 |
| Last Update Date | 10/08/2021 |
| Certification Date | 10/08/2021 |
| Medicare PECOS PAC ID | 4183014293 |
|---|---|
| Medicare Enrollment ID | O20211203002279 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548922438 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Bernadette Itle Crosby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770513160 PECOS PAC ID: 1951311752 Enrollment ID: I20060424000538 |
| Provider Name | Zahra Shariff |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538260492 PECOS PAC ID: 8527084128 Enrollment ID: I20181012000129 |
| Provider Name | Shawn Kelly Pritchett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619441862 PECOS PAC ID: 0648518662 Enrollment ID: I20190215002020 |
| Provider Name | Zaifang Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962975425 PECOS PAC ID: 5092041319 Enrollment ID: I20190724003312 |
| Provider Name | Lisa Faul |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821602087 PECOS PAC ID: 7810308665 Enrollment ID: I20201130000883 |
| Provider Name | Lisette Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326660705 PECOS PAC ID: 9335539444 Enrollment ID: I20211203002385 |
| Provider Name | Michele Lee Merdinger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093347866 PECOS PAC ID: 9436544699 Enrollment ID: I20220325000021 |
| Provider Name | Karmen Lisa Copes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669185609 PECOS PAC ID: 0840663001 Enrollment ID: I20230309000026 |
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