| Passyunk Medical Associates Pc | |
|
1626 E Passyunk Ave Philadelphia PA 19148-1122 | |
| (215) 467-0700 | |
| (215) 467-4457 |
| Full Name | Passyunk Medical Associates Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1626 E Passyunk Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Michael Pisano (DOCTOR) |
| Authorized Official Contact | 2154670700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Passyunk Medical Associates Pc 1626 E Passyunk Ave Philadelphia PA 19148-1122 Ph: (215) 467-0700 | Passyunk Medical Associates Pc 1626 E Passyunk Ave Philadelphia PA 19148-1122 Ph: (215) 467-0700 |
| NPI Number | 1851332589 |
|---|---|
| Provider Enumeration Date | 06/10/2006 |
| Last Update Date | 03/22/2018 |
| Medicare PECOS PAC ID | 4880664994 |
|---|---|
| Medicare Enrollment ID | O20040727001291 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851332589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS007441L (Pennsylvania) | Primary |
| Provider Name | Michael J Pisano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538103924 PECOS PAC ID: 8123098233 Enrollment ID: I20040730000015 |
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