| Philadelphia Family Medicne Assoc P.c. | |
|
1028 W Oregon Ave Philadelphia PA 19148-4421 | |
| (215) 389-7766 | |
| (215) 389-0227 |
| Full Name | Philadelphia Family Medicne Assoc P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 1028 W Oregon Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Joseph P Direnzo (PRESIDENT) |
| Authorized Official Contact | 2153897766 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia Family Medicne Assoc P.c. 1028 W Oregon Ave Philadelphia PA 19148-4421 Ph: (215) 389-7766 | Philadelphia Family Medicne Assoc P.c. 1028 W Oregon Ave Philadelphia PA 19148-4421 Ph: (215) 389-7766 |
| NPI Number | 1912958638 |
|---|---|
| Provider Enumeration Date | 05/15/2006 |
| Last Update Date | 07/15/2021 |
| Medicare PECOS PAC ID | 1254224918 |
|---|---|
| Medicare Enrollment ID | O20040205000884 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912958638 | NPI | - | NPPES |
| 0015771060001 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS009019L (Pennsylvania) | Primary |
| Provider Name | Joseph P Direnzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811991292 PECOS PAC ID: 2860385523 Enrollment ID: I20100129000311 |
| Provider Name | Marc Matozzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437156098 PECOS PAC ID: 2567506595 Enrollment ID: I20100215000438 |
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