| Dr. John Trzesniowski Llc | |
|
2716 E Allegheny Ave Philadelphia PA 19134-5916 | |
| (215) 426-3610 | |
| (215) 426-6835 |
| Full Name | Dr. John Trzesniowski Llc |
|---|---|
| Speciality | General Practice |
| Location | 2716 E Allegheny Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | John G Trzesniowski (PHYSICIAN) |
| Authorized Official Contact | 2154263610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. John Trzesniowski Llc 2716 E Allegheny Ave Philadelphia PA 19134-5916 Ph: (215) 426-3610 | Dr. John Trzesniowski Llc 2716 E Allegheny Ave Philadelphia PA 19134-5916 Ph: (215) 426-3610 |
| NPI Number | 1649692500 |
|---|---|
| Provider Enumeration Date | 01/13/2014 |
| Last Update Date | 01/16/2014 |
| Medicare PECOS PAC ID | 4880811918 |
|---|---|
| Medicare Enrollment ID | O20140813000272 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649692500 | NPI | - | NPPES |
| 0006115620001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | OS003175L (Pennsylvania) | Primary |
| 208D00000X | General Practice | OS016628 (Pennsylvania) | Secondary |
| Provider Name | John G Trzesniowski |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1144264664 PECOS PAC ID: 8820285091 Enrollment ID: I20101214000707 |
| Provider Name | Matthew A Trzesniowski |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487933503 PECOS PAC ID: 1557592409 Enrollment ID: I20140319000000 |
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