| |
834 E Upsal St Philadelphia PA 19119-1541 | |
(215) 924-4440 | |
(610) 525-0852 |
Full Name | |
---|---|
Speciality | Internal Medicine |
Location | 834 E Upsal St, Philadelphia, Pennsylvania |
Authorized Official Name and Position | William L. Laury (CEO) |
Authorized Official Contact | 2159244440 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
834 E Upsal St Philadelphia PA 19119-1541 Ph: (215) 924-4440 | 834 E Upsal St Philadelphia PA 19119-1541 Ph: (215) 924-4440 |
NPI Number | 1528174513 |
---|---|
Provider Enumeration Date | 08/22/2006 |
Last Update Date | 10/18/2023 |
Medicare PECOS PAC ID | 2466727805 |
---|---|
Medicare Enrollment ID | O20171010003423 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528174513 | NPI | - | NPPES |
0006482400004 | Medicaid | PA | |
2166 | Other | PA | BRAVO ELDER HEALTH |
7104021 | Other | PA | AETNA |
075910 | Other | PA | BC BS |
1078975 | Other | PA | KEYSTONE MERCY |
0064824003 | Other | PA | AMERICHOICE OF PA |
P00079200 | Other | PA | RAILROAD MEDICARE |
P526589 | Other | PA | OXFORD HEALTH |
0054066000 | Other | PA | IBC |
37461 | Other | PA | HEALTH PARTNERS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | William L Laury |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1407802697 PECOS PAC ID: 3274794581 Enrollment ID: I20120413000186 |
Laura Yatvin Nutrition Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 N. 5th Street, Philadelphia, PA 19140 Phone: 215-455-5370 Fax: 215-455-5374 | |
Health Hero Pa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 Dickinson St, Philadelphia, PA 19147 Phone: 484-667-3382 | |
Vo Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1735 Market St Fl 52, Philadelphia, PA 19103 Phone: 267-314-7252 | |
Rooted Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Tyson Ave, Philadelphia, PA 19149 Phone: 917-861-2531 | |
Care Health Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1308 Cottman Ave, Philadelphia, PA 19111 Phone: 732-766-1827 Fax: 609-890-0950 | |
University Of Penn - Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, 3 Ravdin, Suite F, Pulmonary & Critical Care, Philadelphia, PA 19104 Phone: 215-662-3202 | |