| Jefferson Women's Primary Care | |
|
834 Walnut St Suite 110 Philadelphia PA 19107-5109 | |
| (215) 503-4779 | |
| Not Available |
| Full Name | Jefferson Women's Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 834 Walnut St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Hristos Ristas (VP OF CONTRACTING) |
| Authorized Official Contact | 2159559298 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Women's Primary Care Po Box 828937 Philadelphia PA 19182-8937 Ph: (215) 503-1240 | Jefferson Women's Primary Care 834 Walnut St Suite 110 Philadelphia PA 19107-5109 Ph: (215) 503-4779 |
| NPI Number | 1407270903 |
|---|---|
| Provider Enumeration Date | 02/05/2014 |
| Last Update Date | 10/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407270903 | NPI | - | NPPES |
| 1007729870101 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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