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10101 Academy Rd Suite 104 Philadelphia PA 19114-1120 | |
| (215) 632-4000 | |
| (215) 632-1661 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 10101 Academy Rd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Ronald Kumor (CEO APS) |
| Authorized Official Contact | 2156124858 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 825395 Philadelphia PA 19182-5395 Ph: (215) 807-8000 | 10101 Academy Rd Suite 104 Philadelphia PA 19114-1120 Ph: (215) 632-4000 |
| NPI Number | 1518092477 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 10/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518092477 | NPI | - | NPPES |
| 1007526250051 | Medicaid | PA | |
| 18170 | Other | PA | HEALTH PARTNERS |
| 379767 | Other | PA | HIGHMARK BLUE SHIELD |
| 379767 | Other | PA | PERSONAL CHOICE |
| 015464001 | Other | PA | KEYSTONE, IBC |
| 1007526250041 | Medicaid | PA | |
| 179943 | Other | PA | HIGHMARK BLUE SHIELD |
| CC4831 | Other | PA | RAILROAD MEDICARE |
| 1007526250039 | Medicaid | PA | |
| 1025866 | Other | PA | KEYSTONE MERCY |
| 18036 | Other | PA | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Pennsylvania) | Primary |
| 207R00000X | Internal Medicine | (Pennsylvania) | Secondary |
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