| Frederick William Randolph, MD | |
|
2607 Rhawn St, Philadelphia, PA 19152-3038 | |
| (215) 333-0304 | |
| (215) 333-1402 |
| Full Name | Frederick William Randolph |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 2607 Rhawn St, Philadelphia, Pennsylvania |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033155247 | NPI | - | NPPES |
| 10433266 | Other | CAQH | |
| 368731700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | D0019085 (Maryland) | Primary |
| 207P00000X | Emergency Medicine | MD447333 (Pennsylvania) | Secondary |
| Entity Name | Jefferson Acute Care Physicians PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730571324 PECOS PAC ID: 7810215613 Enrollment ID: O20150407001063 |
| Mailing Address | Practice Location Address |
|---|---|
| Frederick William Randolph, MD 2607 Rhawn St, Philadelphia, PA 19152-3038 Ph: (215) 333-0304 | Frederick William Randolph, MD 2607 Rhawn St, Philadelphia, PA 19152-3038 Ph: (215) 333-0304 |
Dr. Rika N Omalley, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1020 Sansom St, Suite 239, Philadelphia, PA 19107 Phone: 215-955-6844 Fax: 215-955-2526 |
Rian John Pillitteri, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 230 N Broad St, Philadelphia, PA 19102 Phone: 215-762-7963 |
Kenneth Kleckner, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 5501 Old York Rd, Einstein Medical Center - Philadelphia, Philadelphia, PA 19141 Phone: 215-456-6679 Fax: 215-456-8502 |
Dr. Shruti Chandra, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1020 Sansom St, Suite 239, Philadelphia, PA 19107 Phone: 215-955-6844 Fax: 215-955-2526 |
Ashley Bonsu, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3400 Spruce St, Philadelphia, PA 19104 Phone: 215-316-5151 |
Anthony Joseph Nastasi Jr., MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3400 Spruce St, Ground Silverstein Bldg, Philadelphia, PA 19104 Phone: 215-662-6698 Fax: 215-662-3953 |
Noi Walkenstein, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 2607 Rhawn St, Philadelphia, PA 19152 Phone: 215-333-0304 Fax: 215-333-1402 |