| Pennsport Internal Medicine Group, Pc | |
|
1817 S 2nd St Phila PA 19148-1945 | |
| (215) 389-3368 | |
| (215) 389-1225 |
| Full Name | Pennsport Internal Medicine Group, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1817 S 2nd St, Phila, Pennsylvania |
| Authorized Official Name and Position | Kenneth Winokur (PRESIDENT) |
| Authorized Official Contact | 2153896120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennsport Internal Medicine Group, Pc 1817 S 2nd St Phila PA 19148-1945 Ph: (215) 389-3368 | Pennsport Internal Medicine Group, Pc 1817 S 2nd St Phila PA 19148-1945 Ph: (215) 389-3368 |
| NPI Number | 1114100336 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 04/18/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114100336 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS003325L (Pennsylvania) | Primary |
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