| Roosevelt Family Medical Center, Inc. | |
|
4517 N Broad St Philadelphia PA 19140-1215 | |
| (215) 324-1900 | |
| (215) 324-4239 |
| Full Name | Roosevelt Family Medical Center, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 4517 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Maurice Singer (PRESIDENT) |
| Authorized Official Contact | 2156763336 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roosevelt Family Medical Center, Inc. 4517 N Broad St Philadelphia PA 19140-1215 Ph: (215) 324-1900 | Roosevelt Family Medical Center, Inc. 4517 N Broad St Philadelphia PA 19140-1215 Ph: (215) 324-1900 |
| NPI Number | 1114035326 |
|---|---|
| Provider Enumeration Date | 08/28/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114035326 | NPI | - | NPPES |
| 0058484001 | Other | PA | 10 DIGIT HMO ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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