| Delaware Valley Community Health, Inc. | |
|
1412 Fairmount Ave Philadelphia PA 19130-2908 | |
| (215) 684-5344 | |
| (215) 232-4093 |
| Full Name | Delaware Valley Community Health, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1412 Fairmount Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Alvan Scott Mcneal (PRESIDENT & CEO) |
| Authorized Official Contact | 2156845344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Delaware Valley Community Health, Inc. 1412 Fairmount Ave Philadelphia PA 19130-2908 Ph: (215) 684-5344 | Delaware Valley Community Health, Inc. 1412 Fairmount Ave Philadelphia PA 19130-2908 Ph: (215) 684-5344 |
| NPI Number | 1386864502 |
|---|---|
| Provider Enumeration Date | 04/27/2007 |
| Last Update Date | 12/12/2018 |
| Medicare PECOS PAC ID | 8426967175 |
|---|---|
| Medicare Enrollment ID | O20040617001033 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386864502 | NPI | - | NPPES |
| 100772996 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Irisaida Martinez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164470977 PECOS PAC ID: 3274424049 Enrollment ID: I20040322001256 |
| Provider Name | Sandy Elise Harmon |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1598748568 PECOS PAC ID: 0547227233 Enrollment ID: I20041214000882 |
| Provider Name | Clinton Turner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952384646 PECOS PAC ID: 9436113933 Enrollment ID: I20050217000244 |
| Provider Name | Mary Carol Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902076920 PECOS PAC ID: 9436102738 Enrollment ID: I20060207000351 |
| Provider Name | Alvan Scott Mcneal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083616882 PECOS PAC ID: 4385553924 Enrollment ID: I20060308000214 |
| Provider Name | Barry Brent Simmons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336366467 PECOS PAC ID: 8224109152 Enrollment ID: I20080619000384 |
| Provider Name | Segundo Rodriguez |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467480319 PECOS PAC ID: 8628141389 Enrollment ID: I20080715000102 |
| Provider Name | Joseph P Ruskiewicz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396735668 PECOS PAC ID: 2163570953 Enrollment ID: I20090505000411 |
| Provider Name | Brandy Scombordi-raghu |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1336159268 PECOS PAC ID: 4385785302 Enrollment ID: I20100112000652 |
| Provider Name | Carlo Pelino |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003917378 PECOS PAC ID: 6709918733 Enrollment ID: I20100709000532 |
| Provider Name | Annette O Neil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295719474 PECOS PAC ID: 5092999532 Enrollment ID: I20110407000851 |
| Provider Name | Rafael S Collazo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1528152774 PECOS PAC ID: 1355527011 Enrollment ID: I20110512000796 |
| Provider Name | Henry Su |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174594253 PECOS PAC ID: 0446436547 Enrollment ID: I20110524000843 |
| Provider Name | Greta J. Stewart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235112566 PECOS PAC ID: 9234316878 Enrollment ID: I20110607000556 |
| Provider Name | Luis C Trujillo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619109758 PECOS PAC ID: 0547439895 Enrollment ID: I20110803000446 |
| Provider Name | Sophia M Govorov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316267222 PECOS PAC ID: 2860662723 Enrollment ID: I20110901000090 |
| Provider Name | Ruby Camarena |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144203480 PECOS PAC ID: 9234301243 Enrollment ID: I20111018000311 |
| Provider Name | Maria I Flores |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1003042714 PECOS PAC ID: 5698949055 Enrollment ID: I20111121000467 |
| Provider Name | Mana Golzari |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811143829 PECOS PAC ID: 2769631274 Enrollment ID: I20120927000073 |
| Provider Name | Robert B Watterson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033187646 PECOS PAC ID: 4587813696 Enrollment ID: I20121005000036 |
| Provider Name | Johanna B Owings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437312592 PECOS PAC ID: 2961651633 Enrollment ID: I20121012000696 |
| Provider Name | Daniel Dejoseph |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114123981 PECOS PAC ID: 8224153143 Enrollment ID: I20130205000351 |
| Provider Name | Naomi B Walinsky-king |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043489271 PECOS PAC ID: 9739257007 Enrollment ID: I20131113000673 |
| Provider Name | Donna Sillman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841480282 PECOS PAC ID: 1052598810 Enrollment ID: I20140417000229 |
| Provider Name | Joel Mcintosh |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861819674 PECOS PAC ID: 7315161965 Enrollment ID: I20140623000047 |
| Provider Name | Julia L De Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679776926 PECOS PAC ID: 0143412320 Enrollment ID: I20140715001297 |
| Provider Name | Kira R Delong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851657183 PECOS PAC ID: 3678795788 Enrollment ID: I20141105000764 |
| Provider Name | Meredith E. Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982091344 PECOS PAC ID: 9638499320 Enrollment ID: I20160120002114 |
| Provider Name | Stephanie Leburg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1730531336 PECOS PAC ID: 1153617741 Enrollment ID: I20160908000168 |
| Provider Name | Noel Boquiren Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811305865 PECOS PAC ID: 2860789229 Enrollment ID: I20160928002088 |
| Provider Name | Tosha Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770025033 PECOS PAC ID: 6204118912 Enrollment ID: I20170112002024 |
| Provider Name | Michael J Adams |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1780891838 PECOS PAC ID: 4688941115 Enrollment ID: I20170605000236 |
| Provider Name | Sinu Nair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497205157 PECOS PAC ID: 2062781883 Enrollment ID: I20170710001950 |
| Provider Name | Nikhil Emmanuel Abreo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720508369 PECOS PAC ID: 6002187218 Enrollment ID: I20170807002263 |
| Provider Name | Erin Sherman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1154772614 PECOS PAC ID: 9739467416 Enrollment ID: I20171227002202 |
| Provider Name | Katherine Nicole White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053811919 PECOS PAC ID: 9234493271 Enrollment ID: I20180430000152 |
| Provider Name | Sara Lynn Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821451121 PECOS PAC ID: 7214291269 Enrollment ID: I20180430000313 |
| Provider Name | Erin Elizabeth Held |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285126730 PECOS PAC ID: 1355697582 Enrollment ID: I20180702001059 |
| Provider Name | Yamile Cuevas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245729854 PECOS PAC ID: 0143576926 Enrollment ID: I20180710000357 |
| Provider Name | Maggie A. Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114210952 PECOS PAC ID: 2567719065 Enrollment ID: I20180716000030 |
| Provider Name | Margaret Kathleen Ciavarelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356725022 PECOS PAC ID: 8921356007 Enrollment ID: I20180806002668 |
| Provider Name | Amanda Yvette Montalvo |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1700364148 PECOS PAC ID: 2466701685 Enrollment ID: I20180822000576 |
| Provider Name | Sarah Onafowora |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265847644 PECOS PAC ID: 8729339411 Enrollment ID: I20180919001187 |
| Provider Name | Hadijatou Joyce Jarra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184837874 PECOS PAC ID: 3779675715 Enrollment ID: I20180925001145 |
| Provider Name | Eric T Elvanian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326222472 PECOS PAC ID: 5294072328 Enrollment ID: I20190129000442 |
| Provider Name | Michelle E Schweitzer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407314198 PECOS PAC ID: 0446592034 Enrollment ID: I20190501000904 |
| Provider Name | Nishanth Sidduri |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811378979 PECOS PAC ID: 1850620659 Enrollment ID: I20190904000397 |
| Provider Name | Pamela A Alva Porroa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477023307 PECOS PAC ID: 8022440031 Enrollment ID: I20191113001104 |
| Provider Name | Elana Levites-agababa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669793063 PECOS PAC ID: 0749523470 Enrollment ID: I20200303001422 |
| Provider Name | Allison Nicole Vogl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336674670 PECOS PAC ID: 8527327899 Enrollment ID: I20200715001559 |
| Provider Name | Kelsey Elizabeth Mcglade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700316932 PECOS PAC ID: 2264857572 Enrollment ID: I20200804001587 |
| Provider Name | Alicia M Rivera Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518577188 PECOS PAC ID: 7810313533 Enrollment ID: I20200812001677 |
| Provider Name | Daniel Ring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265966063 PECOS PAC ID: 8325319981 Enrollment ID: I20201002000016 |
| Provider Name | Karen J Lazarus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356834824 PECOS PAC ID: 8628325677 Enrollment ID: I20210806002294 |
| Provider Name | Anne Sprogell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598258667 PECOS PAC ID: 2466709290 Enrollment ID: I20210816001776 |
| Provider Name | Cameron Grant Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962932897 PECOS PAC ID: 1850661976 Enrollment ID: I20210903001093 |
| Provider Name | Ivan Rafael Lockward |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922589480 PECOS PAC ID: 2567869498 Enrollment ID: I20210920003683 |
| Provider Name | Julian Sacca-schaeffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710482393 PECOS PAC ID: 3274879176 Enrollment ID: I20210921001396 |
| Provider Name | Amulya Iyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619409281 PECOS PAC ID: 5597175190 Enrollment ID: I20211119000042 |
| Provider Name | Camille Lawhead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205446218 PECOS PAC ID: 4183034598 Enrollment ID: I20220127000839 |
| Provider Name | Stephanie Chery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326400417 PECOS PAC ID: 4587083985 Enrollment ID: I20220301000438 |
| Provider Name | Ramon Danilo Penaranda |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1861148868 PECOS PAC ID: 5698161594 Enrollment ID: I20220401000140 |
| Provider Name | Evan Ryan Gooberman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114486909 PECOS PAC ID: 8527393180 Enrollment ID: I20220613002667 |
| Provider Name | Melanie Nicole Cristobal |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1699343244 PECOS PAC ID: 1355724238 Enrollment ID: I20220810003795 |
| Provider Name | Denise Diaz Aguayo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700512670 PECOS PAC ID: 4082098991 Enrollment ID: I20220826000078 |
| Provider Name | Allyson Anne Petosa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003520628 PECOS PAC ID: 8224400163 Enrollment ID: I20230202001691 |
| Provider Name | Lucia Tome |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760910467 PECOS PAC ID: 6406272467 Enrollment ID: I20230228000903 |
| Provider Name | Devon Kuser |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356844047 PECOS PAC ID: 1557735180 Enrollment ID: I20230323000105 |
| Provider Name | Rebecca Anne Hosey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457116394 PECOS PAC ID: 0042657173 Enrollment ID: I20240325001274 |
| Provider Name | Rachel Marie Klinges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386354876 PECOS PAC ID: 7810336401 Enrollment ID: I20240416000641 |
| Provider Name | Mahreen R. Qureshi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508175969 PECOS PAC ID: 4880033380 Enrollment ID: I20240417000795 |
| Provider Name | Caitlin Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194301077 PECOS PAC ID: 8426447707 Enrollment ID: I20240918003471 |
| Provider Name | Bryce Eng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063099042 PECOS PAC ID: 3476956764 Enrollment ID: I20240924000822 |
| Provider Name | Azucena Villalobos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952701864 PECOS PAC ID: 4981137908 Enrollment ID: I20241030000755 |
| Provider Name | Riley Anne Juanita Weidle Babich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407435183 PECOS PAC ID: 6800320284 Enrollment ID: I20241107001199 |
| Provider Name | Sarah Zimmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720644644 PECOS PAC ID: 7315270881 Enrollment ID: I20241210004844 |
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