| Phillymedclub Pllc | |
|
1300 N 2nd St Ofc 101 Philadelphia PA 19122-4594 | |
| (215) 776-7308 | |
| Not Available |
| Full Name | Phillymedclub Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1300 N 2nd St Ofc 101, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Wayne Christopher Raneiro (CMO) |
| Authorized Official Contact | 2157767308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Phillymedclub Pllc 1300 N 2nd St Ofc 101 Philadelphia PA 19122-4594 Ph: (215) 776-7308 | Phillymedclub Pllc 1300 N 2nd St Ofc 101 Philadelphia PA 19122-4594 Ph: (215) 776-7308 |
| NPI Number | 1912642703 |
|---|---|
| Provider Enumeration Date | 05/05/2022 |
| Last Update Date | 05/05/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912642703 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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