| Philadelphia Gastroenterology Consultants Ltd. | |
|
700 Cottman Ave Suite 201 Philadelphia PA 19111-3062 | |
| (215) 742-9900 | |
| (215) 742-7051 |
| Full Name | Philadelphia Gastroenterology Consultants Ltd. |
|---|---|
| Speciality | Internal Medicine |
| Location | 700 Cottman Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Mark S. Tanker (PRESIDENT) |
| Authorized Official Contact | 2157429900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia Gastroenterology Consultants Ltd. 700 Cottman Ave Suite 201 Philadelphia PA 19111-3062 Ph: (215) 742-9900 | Philadelphia Gastroenterology Consultants Ltd. 700 Cottman Ave Suite 201 Philadelphia PA 19111-3062 Ph: (215) 742-9900 |
| NPI Number | 1861425613 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 10/30/2007 |
| Medicare PECOS PAC ID | 8921079443 |
|---|---|
| Medicare Enrollment ID | O20040805001201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861425613 | NPI | - | NPPES |
| 001647855/0005 | Medicaid | PA | |
| 001647855/0004 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Mark S Tanker |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831137538 PECOS PAC ID: 6608808415 Enrollment ID: I20050901000058 |
| Provider Name | Corey S Brotz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609081041 PECOS PAC ID: 3072699297 Enrollment ID: I20080617000119 |
| Provider Name | Shiban K Raina |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972528610 PECOS PAC ID: 7810098639 Enrollment ID: I20101004000487 |
| Provider Name | Bruce Gelman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699790790 PECOS PAC ID: 7214961705 Enrollment ID: I20101005000244 |
| Provider Name | Richard E Moses |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588689525 PECOS PAC ID: 4183725906 Enrollment ID: I20101006000954 |
| Provider Name | Daniel J Sher |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225053259 PECOS PAC ID: 7911000575 Enrollment ID: I20101029001241 |
| Provider Name | Denise Deriane Najjar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1104911718 PECOS PAC ID: 2860663101 Enrollment ID: I20110919000400 |
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