| Jalil Nasibli, MD | |
|
3401 N Broad St, Philadelphia, PA 19140-5189 | |
| (215) 707-4353 | |
| (215) 707-2781 |
| Full Name | Jalil Nasibli |
|---|---|
| Gender | Male |
| Speciality | Pathology - Clinical Pathology |
| Location | 3401 N Broad 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 |
|---|---|---|---|
| 1497249692 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207ZC0006X | Pathology - Clinical Pathology | MD476462 (Pennsylvania) | Primary |
| Entity Name | Temple Faculty Practice Plan Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1881176949 PECOS PAC ID: 0345588711 Enrollment ID: O20190208002623 |
| Mailing Address | Practice Location Address |
|---|---|
| Jalil Nasibli, MD 3500 N Broad St, Philadelphia, PA 19140-4106 Ph: (215) 707-3411 | Jalil Nasibli, MD 3401 N Broad St, Philadelphia, PA 19140-5189 Ph: (215) 707-4353 |
Jason Nathaniel Rosenbaum, M.D. Pathology Medicare: Medicare Enrolled Practice Location: 800 Spruce St, Philadelphia, PA 19107 Phone: 215-829-3000 Fax: 215-829-7564 | |
Dr. Vivianna Maia Van Deerlin, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 3400 Spruce Street, 7.103 Founders Pavillion, Philadelphia, PA 19104 Phone: 215-662-6550 Fax: 215-662-7529 | |
Zissimos Mourelatos, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 800 Spruce St, Philadelphia, PA 19107 Phone: 215-829-3000 Fax: 215-829-7564 | |
Mariusz A Wasik, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 333 Cottman Ave, Philadelphia, PA 19111 Phone: 215-728-3675 Fax: 215-728-2848 | |
Adrienne Catharine Carruth Griffin, MD Pathology Medicare: Not Enrolled in Medicare Practice Location: 3400 Spruce St, 1 Maloney Building, Philadelphia, PA 19104 Phone: 215-662-4829 | |
Tirumala Lakshmi Kumari Pentakota, M.D Pathology Medicare: Not Enrolled in Medicare Practice Location: 245 N 15th St, Mail Stop 435, Philadelphia, PA 19102 Phone: 215-762-1179 | |
Matthew B Palmer, MD Pathology Medicare: Accepting Medicare Assignments Practice Location: 800 Spruce St, Philadelphia, PA 19107 Phone: 215-829-3000 Fax: 215-829-7564 |