| Penn Presbyterian Medical Ctr Iop | |
|
51 N 39th St Phila PA 19104-2640 | |
| (215) 796-4640 | |
| (609) 770-7792 |
| Full Name | Penn Presbyterian Medical Ctr Iop |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 51 N 39th St, Phila, Pennsylvania |
| Authorized Official Name and Position | Thomas Mccormick (ASSISTANT VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 2157620888 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Penn Presbyterian Medical Ctr Iop 1500 Market St Um600 Phila PA 19102-2100 Ph: (215) 796-4640 | Penn Presbyterian Medical Ctr Iop 51 N 39th St Phila PA 19104-2640 Ph: (215) 796-4640 |
| NPI Number | 1649310103 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 03/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649310103 | NPI | - | NPPES |
| 1007297070026 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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