| Philadelphia College Of Osteopathic Medicine | |
|
4190 City Ave Philadelphia PA 19131-1633 | |
| (215) 871-6910 | |
| (251) 871-6905 |
| Full Name | Philadelphia College Of Osteopathic Medicine |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 4190 City Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Kenneth Veit (SVP OF ACADEMIC AFFAIRS AND DEAN) |
| Authorized Official Contact | 2158716770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Philadelphia College Of Osteopathic Medicine 4190 City Ave Suite 777 Philadelphia PA 19131-1633 Ph: (215) 871-6910 | Philadelphia College Of Osteopathic Medicine 4190 City Ave Philadelphia PA 19131-1633 Ph: (215) 871-6910 |
| NPI Number | 1316230220 |
|---|---|
| Provider Enumeration Date | 05/25/2011 |
| Last Update Date | 01/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316230220 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PS016978 (Pennsylvania) | Primary |
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