| South Philly East Health And Wellness | |
|
1902 S 8th Street Philadelphia PA 19148 | |
| (215) 503-7194 | |
| Not Available |
| Full Name | South Philly East Health And Wellness |
|---|---|
| Speciality | Family Medicine |
| Location | 1902 S 8th Street, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Corinne Lagermasini (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2677923033 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Philly East Health And Wellness 1902 S 8th St Philadelphia PA 19148-2434 Ph: () - | South Philly East Health And Wellness 1902 S 8th Street Philadelphia PA 19148 Ph: (215) 503-7194 |
| NPI Number | 1194481754 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 02/29/2024 |
| Medicare PECOS PAC ID | 3375999717 |
|---|---|
| Medicare Enrollment ID | O20231021000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194481754 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Marc Jay Altshuler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013935220 PECOS PAC ID: 5193796076 Enrollment ID: I20040804000410 |
| Provider Name | Jessica Lee Deffler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063945400 PECOS PAC ID: 4082982533 Enrollment ID: I20200928000060 |
| Provider Name | Winnie Musoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710608252 PECOS PAC ID: 1052773785 Enrollment ID: I20230814000137 |
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