| Pennsylvania Internal Medicine & Geriatrics Pc | |
|
9503 State Rd Philadelphia PA 19114-3034 | |
| (215) 637-0102 | |
| (215) 281-0464 |
| Full Name | Pennsylvania Internal Medicine & Geriatrics Pc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 9503 State Rd, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Herbert M Bergman (PHYSICIAN) |
| Authorized Official Contact | 2156370102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pennsylvania Internal Medicine & Geriatrics Pc 9501 Hilspach St Philadelphia PA 19115-3918 Ph: (215) 637-0102 | Pennsylvania Internal Medicine & Geriatrics Pc 9503 State Rd Philadelphia PA 19114-3034 Ph: (215) 637-0102 |
| NPI Number | 1134365620 |
|---|---|
| Provider Enumeration Date | 01/05/2009 |
| Last Update Date | 10/14/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134365620 | NPI | - | NPPES |
| 000592556 | Medicaid | PA | |
| 835253 | Other | PA | AETNA INSURANCE |
| 0053907001 | Other | PA | KEYSTONE HEALTH PLAN EAST |
| 110026458 | Other | PA | PALMETTO GBA MEDICARE RAILROAD |
| 129328701 | Other | PA | UNITED HEALTHCARE |
| 035806 | Other | PA | HIGHMARK MEDICARE SERVICES |
| 19361 | Other | PA | BRAVO HEALTHCRE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | MD012582E (Pennsylvania) | Primary |
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