| Temple University Of The Commonwealth System Of Higher Education | |
|
3322 N Broad St Philadelphia PA 19140-5103 | |
| (215) 707-1800 | |
| (215) 707-3644 |
| Full Name | Temple University Of The Commonwealth System Of Higher Education |
|---|---|
| Speciality | Family Medicine - Geriatric Medicine |
| Location | 3322 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Tonya Woodard (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2157073911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Temple University Of The Commonwealth System Of Higher Education 2450 W Hunting Park Ave Philadelphia PA 19129-1302 Ph: (215) 707-1800 | Temple University Of The Commonwealth System Of Higher Education 3322 N Broad St Philadelphia PA 19140-5103 Ph: (215) 707-1800 |
| NPI Number | 1992794648 |
|---|---|
| Provider Enumeration Date | 10/17/2005 |
| Last Update Date | 06/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992794648 | NPI | - | NPPES |
| 1007780130816 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QG0300X | Family Medicine - Geriatric Medicine | (Pennsylvania) | Primary |
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