| Philadelphia Gastroenterology Group, P.c. | |
|
525 Jamestown St Suite 101 Philadelphia PA 19128-1751 | |
| (215) 463-1483 | |
| (215) 483-9185 |
| Full Name | Philadelphia Gastroenterology Group, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 525 Jamestown St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Annamarie Andrews (OFFICE MANAGER) |
| Authorized Official Contact | 2154631483 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia Gastroenterology Group, P.c. 525 Jamestown St Suite 101 Philadelphia PA 19128-1751 Ph: (215) 463-1483 | Philadelphia Gastroenterology Group, P.c. 525 Jamestown St Suite 101 Philadelphia PA 19128-1751 Ph: (215) 463-1483 |
| NPI Number | 1801826177 |
|---|---|
| Provider Enumeration Date | 07/03/2006 |
| Last Update Date | 02/14/2017 |
| Medicare PECOS PAC ID | 3274430459 |
|---|---|
| Medicare Enrollment ID | O20050211000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801826177 | NPI | - | NPPES |
| 000893827-0001 | Medicaid | PA | |
| 0055417 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Beth C Gardner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457334369 PECOS PAC ID: 5698727204 Enrollment ID: I20050211000299 |
| Provider Name | Larry M. Borowsky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174506729 PECOS PAC ID: 8921056979 Enrollment ID: I20051208000235 |
| Provider Name | Noel B Martins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1740212281 PECOS PAC ID: 2567451826 Enrollment ID: I20070716000159 |
| Provider Name | Theresa M Disandro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1750544391 PECOS PAC ID: 5597818377 Enrollment ID: I20090727000308 |
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