| Fairmount Pediatrics And Adolescent Medicine | |
|
2000 Hamilton St #109 Phila PA 19130-3814 | |
| (215) 774-1166 | |
| (215) 279-8383 |
| Full Name | Fairmount Pediatrics And Adolescent Medicine |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2000 Hamilton St, Phila, Pennsylvania |
| Authorized Official Name and Position | Alexis S Lieberman (MEMBER MANAGER) |
| Authorized Official Contact | 2157741166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmount Pediatrics And Adolescent Medicine 7042 Greene St Phila PA 19119-3439 Ph: (215) 990-6625 | Fairmount Pediatrics And Adolescent Medicine 2000 Hamilton St #109 Phila PA 19130-3814 Ph: (215) 774-1166 |
| NPI Number | 1487987020 |
|---|---|
| Provider Enumeration Date | 09/15/2009 |
| Last Update Date | 09/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487987020 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MD059659L (Pennsylvania) | Primary |
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