| Mercy Catholic Medical Center Of Southeastern Pa | |
|
1503 Lansdowne Avenue Suite 2000 Philadelphia PA 19143-1900 | |
| (610) 237-3646 | |
| (610) 237-4261 |
| Full Name | Mercy Catholic Medical Center Of Southeastern Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1503 Lansdowne Avenue, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Phyllis Hilker (V.P. FINANCE) |
| Authorized Official Contact | 6105676967 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Catholic Medical Center Of Southeastern Pa 1 W Elm St Suite 100 Conshohocken PA 19428-4108 Ph: (610) 567-6967 | Mercy Catholic Medical Center Of Southeastern Pa 1503 Lansdowne Avenue Suite 2000 Philadelphia PA 19143-1900 Ph: (610) 237-3646 |
| NPI Number | 1437130705 |
|---|---|
| Provider Enumeration Date | 11/14/2005 |
| Last Update Date | 01/30/2018 |
| Medicare PECOS PAC ID | 3678476561 |
|---|---|
| Medicare Enrollment ID | O20040408000889 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437130705 | NPI | - | NPPES |
| 025024 | Other | PA | HEALTHPARTNERS |
| 30001873 | Other | PA | KMHP |
| G0006731 | Other | PA | AMERICHOICE |
| 372921 | Other | PA | HIGHMARK BLUE SHIELD |
| 0114720000 | Other | PA | KHPE |
| G0007408 | Other | PA | AMERICHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
| Provider Name | Leo Zacharias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346221777 PECOS PAC ID: 6709875024 Enrollment ID: I20040511000562 |
| Provider Name | Daniel John Sung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588619969 PECOS PAC ID: 0749283091 Enrollment ID: I20060807000315 |
| Provider Name | Steven R Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982602876 PECOS PAC ID: 8527167659 Enrollment ID: I20070629000533 |
| Provider Name | Eric Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235214008 PECOS PAC ID: 5395720460 Enrollment ID: I20100913000814 |
| Provider Name | Mrunal Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598172066 PECOS PAC ID: 3779858006 Enrollment ID: I20171012000309 |
| Provider Name | Meghana Vijay Dhamdhere |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437462710 PECOS PAC ID: 1557684990 Enrollment ID: I20200720000091 |
| Provider Name | Sarah Kathryn Mirabello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841714623 PECOS PAC ID: 4789025032 Enrollment ID: I20240712000079 |
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