| Temple University Of The Commonwealth System Of Higher Education | |
|
1700 N Broad St Philadelphia PA 19121-3429 | |
| (215) 204-2679 | |
| (215) 204-1784 |
| Full Name | Temple University Of The Commonwealth System Of Higher Education |
|---|---|
| Speciality | Internal Medicine |
| Location | 1700 N Broad St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Bridget Ferrarie (MANAGER, CREDENTIALING) |
| Authorized Official Contact | 2157072433 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Temple University Of The Commonwealth System Of Higher Education 1700 N Broad St Philadelphia PA 19121-3429 Ph: (215) 204-2679 | Temple University Of The Commonwealth System Of Higher Education 1700 N Broad St Philadelphia PA 19121-3429 Ph: (215) 204-2679 |
| NPI Number | 1235701392 |
|---|---|
| Provider Enumeration Date | 07/16/2021 |
| Last Update Date | 07/16/2021 |
| Medicare PECOS PAC ID | 2961314299 |
|---|---|
| Medicare Enrollment ID | O20211019001645 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235701392 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Leslie E Everts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750434692 PECOS PAC ID: 6901940428 Enrollment ID: I20100223000053 |
| Provider Name | Maria Pellecchia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366455024 PECOS PAC ID: 5890988307 Enrollment ID: I20101015001195 |
| Provider Name | Ben Hur Mobo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477651453 PECOS PAC ID: 8527283167 Enrollment ID: I20140715001777 |
| Provider Name | Dorrit H Sterner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063636181 PECOS PAC ID: 3072892900 Enrollment ID: I20161117001173 |
| Provider Name | Sarah Sherr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639229909 PECOS PAC ID: 3971552704 Enrollment ID: I20161208000799 |
| Provider Name | Nancy B Andresen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013137892 PECOS PAC ID: 4082984067 Enrollment ID: I20170725000257 |
| Provider Name | Michael David Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225188998 PECOS PAC ID: 2769740026 Enrollment ID: I20171215000216 |
| Provider Name | Nasreen Malik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669681821 PECOS PAC ID: 9032457387 Enrollment ID: I20190212000004 |
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