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8127 Stenton Ave Philadelphia PA 19150-3530 | |
| (267) 331-9832 | |
| (267) 331-9932 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 8127 Stenton Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Susan Denise Stukes (CEO) |
| Authorized Official Contact | 2158441020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
8127 Stenton Ave Philadelphia PA 19150-3530 Ph: (267) 331-9832 | 8127 Stenton Ave Philadelphia PA 19150-3530 Ph: (267) 331-9832 |
| NPI Number | 1699190561 |
|---|---|
| Provider Enumeration Date | 02/28/2014 |
| Last Update Date | 09/20/2023 |
| Medicare PECOS PAC ID | 3476591686 |
|---|---|
| Medicare Enrollment ID | O20200127000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699190561 | NPI | - | NPPES |
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