Gina Diana Moore, MPT | |
511 N Broad St, Philadelphia, PA 19123-3230 | |
(215) 923-6031 | |
(215) 923-8269 |
Full Name | Gina Diana Moore |
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Gender | Female |
Speciality | Physical Therapist |
Location | 511 N Broad St, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376740712 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PT009919E (Pennsylvania) | Primary |
Provider Name | Advance Therapy Associates, Inc. |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1780959718 PECOS PAC ID: 4284897455 Enrollment ID: O20120525000410 |
Mailing Address | Practice Location Address |
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Gina Diana Moore, MPT 4812 N 5th St, Philadelphia, PA 19120-4125 Ph: (215) 324-6082 | Gina Diana Moore, MPT 511 N Broad St, Philadelphia, PA 19123-3230 Ph: (215) 923-6031 |
Mr. James Blakely, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1555 E Wadsworth Ave, Unit 1, Philadelphia, PA 19150 Phone: 267-323-2778 Fax: 267-323-2774 | |
Vincent Ngo, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 133 W Hunting Park Ave, Philadelphia, PA 19140 Phone: 215-455-5370 | |
Maureen Higgins, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 190 N Independence Mall W, Philadelphia, PA 19106 Phone: 215-413-0600 Fax: 215-413-0684 | |
Jennifer Dekerlegand, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3400 Spruce St, 1 White Building, Philadelphia, PA 19104 Phone: 215-662-3265 | |
Doriean Broady, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4902 Arch St Unit 1, Philadelphia, PA 19139 Phone: 585-944-7961 | |
Jennifer Anne Ellis, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1923 Bainbridge St, Philadelphia, PA 19146 Phone: 215-469-1832 | |
Katherine Weaver, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3400 Lancaster Ave Ste 4, Philadelphia, PA 19104 Phone: 215-662-0397 |