| Neurology- General | |
|
833 Chestnut St Suite 630 Philadelphia PA 19107-4414 | |
| (215) 955-0800 | |
| Not Available |
| Full Name | Neurology- General |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 833 Chestnut St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Hristos Ristas (VP OF CONTRACTING) |
| Authorized Official Contact | 2159559298 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurology- General Po Box 828937 Suite 630 Philadelphia PA 19182-8937 Ph: (215) 503-1240 | Neurology- General 833 Chestnut St Suite 630 Philadelphia PA 19107-4414 Ph: (215) 955-0800 |
| NPI Number | 1295909422 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 10/14/2022 |
| Certification Date | 10/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295909422 | NPI | - | NPPES |
| 48506 | Other | PA | KEYSTONE MERCY |
| 0444973000 | Other | PA | INDEPENDENCE BLUE CROSS |
| 7696507 | Medicaid | NJ | |
| 959656 | Other | PA | HIGHMARK BLUE SHIELD |
| 955345 | Other | PA | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | () | Primary |
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