| University Of Penn-medical Group | |
|
3400 Spruce St 3 Silverstein Building, Suite D Philadelphia PA 19104-4206 | |
| (215) 662-6932 | |
| (215) 662-7899 |
| Full Name | University Of Penn-medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 3400 Spruce St, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | Chante L Jackson (ENROLLMENT LEAD) |
| Authorized Official Contact | 2156626187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Penn-medical Group 3400 Spruce St Philadelphia PA 19104-4206 Ph: (215) 662-6932 | University Of Penn-medical Group 3400 Spruce St 3 Silverstein Building, Suite D Philadelphia PA 19104-4206 Ph: (215) 662-6932 |
| NPI Number | 1194832899 |
|---|---|
| Provider Enumeration Date | 08/25/2006 |
| Last Update Date | 11/19/2020 |
| Medicare PECOS PAC ID | 6204730955 |
|---|---|
| Medicare Enrollment ID | O20150221000070 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194832899 | NPI | - | NPPES |
| 0002Y20116 | Other | PA | HEALTHNET |
| 043054 | Other | PA | BLUE SHIELD |
| 1010882 | Other | PA | MERCY |
| 496686 | Other | PA | AETNA |
| 10724 | Other | PA | HEALTHPARTNERS |
| 5467403 | Other | PA | NJ-MEDICAID |
| CA0235 | Other | PA | RR MEDICARE |
| 0345789000 | Other | PA | KEYSTONE |
| 0006610360 | Medicaid | PA | |
| 273224 | Other | PA | MAMSI |
| G00048530 | Other | PA | AMERICHOICE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| 2080P0208X | Pediatrics - Pediatric Infectious Diseases | (* (Not Available)) | Secondary |
| Provider Name | William R Short |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669414827 PECOS PAC ID: 7911811948 Enrollment ID: I20031114000219 |
| Provider Name | Randi S Silibovsky |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1629099981 PECOS PAC ID: 5092618629 Enrollment ID: I20040130000105 |
| Provider Name | Janet M Hines |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1134159254 PECOS PAC ID: 8921091273 Enrollment ID: I20040405000572 |
| Provider Name | Valerianna Klara Amorosa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1679673875 PECOS PAC ID: 3173511946 Enrollment ID: I20040503000519 |
| Provider Name | Vincent Lore |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154357853 PECOS PAC ID: 9335130632 Enrollment ID: I20040524000786 |
| Provider Name | Joanne T Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396899662 PECOS PAC ID: 9638160948 Enrollment ID: I20040524000849 |
| Provider Name | Judith Anne O'donnell |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1780636399 PECOS PAC ID: 9032172564 Enrollment ID: I20041105000718 |
| Provider Name | Ebbing Lautenbach |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649200767 PECOS PAC ID: 7911957956 Enrollment ID: I20050127000060 |
| Provider Name | Zsofia Szep |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588651491 PECOS PAC ID: 6507802303 Enrollment ID: I20050701000443 |
| Provider Name | Todd D Barton |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1629000906 PECOS PAC ID: 4880608884 Enrollment ID: I20060130000294 |
| Provider Name | Helen Carol Koenig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558309104 PECOS PAC ID: 1658384185 Enrollment ID: I20060728000165 |
| Provider Name | Carol Ann Mclaughlin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124047675 PECOS PAC ID: 6204831936 Enrollment ID: I20061002000161 |
| Provider Name | Karam C Mounzer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265571152 PECOS PAC ID: 1456443498 Enrollment ID: I20070822001383 |
| Provider Name | Laura Bamford |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750435996 PECOS PAC ID: 1557453438 Enrollment ID: I20070823000164 |
| Provider Name | Ingi Lee |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538213822 PECOS PAC ID: 8123110665 Enrollment ID: I20070828000932 |
| Provider Name | Blair C Weikert |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1457413445 PECOS PAC ID: 4789756206 Enrollment ID: I20080627000485 |
| Provider Name | Jennifer Elizabeth Cohn |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1992868491 PECOS PAC ID: 0042362766 Enrollment ID: I20090710000133 |
| Provider Name | Amy Chang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033320023 PECOS PAC ID: 8729132022 Enrollment ID: I20090821000037 |
| Provider Name | Florence M Momplaisir |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1336379213 PECOS PAC ID: 8628115425 Enrollment ID: I20091028000115 |
| Provider Name | Richard J Maniglia |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1548299076 PECOS PAC ID: 6800936220 Enrollment ID: I20091216000224 |
| Provider Name | Neil O Fishman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902838378 PECOS PAC ID: 6608901558 Enrollment ID: I20100317000120 |
| Provider Name | Anne H Norris |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1639105877 PECOS PAC ID: 1951436609 Enrollment ID: I20100319000164 |
| Provider Name | Patrick J Brennan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205868502 PECOS PAC ID: 1254321433 Enrollment ID: I20100323000853 |
| Provider Name | Mindy G Schuster |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811929102 PECOS PAC ID: 1153457379 Enrollment ID: I20100326000887 |
| Provider Name | Harvey Rubin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1265464697 PECOS PAC ID: 8527194273 Enrollment ID: I20100405000091 |
| Provider Name | Harvey Friedman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447282728 PECOS PAC ID: 8022144799 Enrollment ID: I20100405000348 |
| Provider Name | Emily A Blumberg |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1043247935 PECOS PAC ID: 3476689092 Enrollment ID: I20100407000163 |
| Provider Name | Pablo M Tebas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1659307346 PECOS PAC ID: 6800922485 Enrollment ID: I20100408000023 |
| Provider Name | Phillip Aaron Green |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538191812 PECOS PAC ID: 4082740741 Enrollment ID: I20100414000208 |
| Provider Name | Ian Frank |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1386676740 PECOS PAC ID: 5890823801 Enrollment ID: I20100512001045 |
| Provider Name | Rahul M Kohli |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1225174105 PECOS PAC ID: 3971658568 Enrollment ID: I20100625000421 |
| Provider Name | Keith W Hamilton |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1548323843 PECOS PAC ID: 5698963361 Enrollment ID: I20101222000049 |
| Provider Name | Marissa B Wilck |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669456596 PECOS PAC ID: 4880644376 Enrollment ID: I20110114000622 |
| Provider Name | Jennifer H Han |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891999256 PECOS PAC ID: 9830286392 Enrollment ID: I20110127000360 |
| Provider Name | Stephen J Gluckman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932136850 PECOS PAC ID: 8022298298 Enrollment ID: I20110204000231 |
| Provider Name | Naasha Talati |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982867958 PECOS PAC ID: 4981778933 Enrollment ID: I20110713000457 |
| Provider Name | Jerry Jacob |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902068273 PECOS PAC ID: 7618145095 Enrollment ID: I20110801000134 |
| Provider Name | David Pegues |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881614048 PECOS PAC ID: 8527076520 Enrollment ID: I20111222000325 |
| Provider Name | Katharine Bar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942337670 PECOS PAC ID: 6709818651 Enrollment ID: I20120123000551 |
| Provider Name | Stacey B. Trooskin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073716296 PECOS PAC ID: 7810150083 Enrollment ID: I20120525000413 |
| Provider Name | Brendan J Kelly |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1598924532 PECOS PAC ID: 9234393646 Enrollment ID: I20120615000160 |
| Provider Name | Valerie C Cluzet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619136660 PECOS PAC ID: 9436283389 Enrollment ID: I20121022000006 |
| Provider Name | Sarah Andzia Longworth |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104143502 PECOS PAC ID: 4183866791 Enrollment ID: I20130812000279 |
| Provider Name | Ramin S Herati |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356501142 PECOS PAC ID: 5698909521 Enrollment ID: I20131009000615 |
| Provider Name | Alysa Beth Krain |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1205272499 PECOS PAC ID: 3779473749 Enrollment ID: I20140708001037 |
| Provider Name | Eileen S Donaghy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376657585 PECOS PAC ID: 8527389543 Enrollment ID: I20150603000310 |
| Provider Name | Jessie L Torgersen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750607917 PECOS PAC ID: 6800107186 Enrollment ID: I20150615000387 |
| Provider Name | Jonathan J Nunez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1508039843 PECOS PAC ID: 5496066870 Enrollment ID: I20150626000107 |
| Provider Name | Maxwell A Parrish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528387255 PECOS PAC ID: 1153545322 Enrollment ID: I20150721001423 |
| Provider Name | Matthew J Culyba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295053379 PECOS PAC ID: 3173837952 Enrollment ID: I20150807013113 |
| Provider Name | Delisha Breen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235504812 PECOS PAC ID: 0941503965 Enrollment ID: I20160126001611 |
| Provider Name | Judith Anesi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902191695 PECOS PAC ID: 3476714874 Enrollment ID: I20160525000694 |
| Provider Name | Dagan E Coppock |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982886750 PECOS PAC ID: 3678648375 Enrollment ID: I20160526000508 |
| Provider Name | Kathleen Marie Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669817383 PECOS PAC ID: 8820388820 Enrollment ID: I20160603000412 |
| Provider Name | Patricia O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801245584 PECOS PAC ID: 0345532651 Enrollment ID: I20160707000457 |
| Provider Name | Courtney Leigh Russ-friedman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750621983 PECOS PAC ID: 4981842481 Enrollment ID: I20160914001169 |
| Provider Name | Shafinaz Akhter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710040431 PECOS PAC ID: 4587719042 Enrollment ID: I20160923000686 |
| Provider Name | Matthew James Ziegler |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740549088 PECOS PAC ID: 8628201753 Enrollment ID: I20170707001943 |
| Provider Name | Kathleen O'neil Degnan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497016281 PECOS PAC ID: 6002054947 Enrollment ID: I20170921003655 |
| Provider Name | Michael Zdenek David |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891912648 PECOS PAC ID: 0749332872 Enrollment ID: I20171020000091 |
| Provider Name | Jillian Baron |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215239843 PECOS PAC ID: 6204054190 Enrollment ID: I20171108000085 |
| Provider Name | Jessica Lynn Bechini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477068237 PECOS PAC ID: 8325307911 Enrollment ID: I20180104000564 |
| Provider Name | Leah Rose Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538663216 PECOS PAC ID: 8022371822 Enrollment ID: I20180409001777 |
| Provider Name | Lauren Dutcher |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1841635687 PECOS PAC ID: 1759682016 Enrollment ID: I20180803001677 |
| Provider Name | Jessica Ann Meisner |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124465653 PECOS PAC ID: 9638427412 Enrollment ID: I20180810000990 |
| Provider Name | Kathryn Ann Whitaker |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821330622 PECOS PAC ID: 0941527600 Enrollment ID: I20180925000153 |
| Provider Name | Jaqueline Dennise Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255805990 PECOS PAC ID: 9931447083 Enrollment ID: I20190214002088 |
| Provider Name | Jeffrey Doyon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245643634 PECOS PAC ID: 5698992907 Enrollment ID: I20190605001326 |
| Provider Name | Dovie Watson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1568875342 PECOS PAC ID: 4284858242 Enrollment ID: I20190712000219 |
| Provider Name | Peter Liu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710220504 PECOS PAC ID: 6608005418 Enrollment ID: I20190805002700 |
| Provider Name | Susan Tark Spinello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639344039 PECOS PAC ID: 9335570662 Enrollment ID: I20200520002153 |
| Provider Name | Audrey Mahajan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881072338 PECOS PAC ID: 0244548253 Enrollment ID: I20200925001628 |
| Provider Name | Erica Jordyn Weinstein |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801281340 PECOS PAC ID: 9739474339 Enrollment ID: I20201102000222 |
| Provider Name | Nancy Aitcheson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1184019697 PECOS PAC ID: 1456761386 Enrollment ID: I20201105000071 |
| Provider Name | Alberta James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629680020 PECOS PAC ID: 4789095720 Enrollment ID: I20201124001741 |
| Provider Name | Nicole Bock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376107839 PECOS PAC ID: 8921333287 Enrollment ID: I20201211000456 |
| Provider Name | Cedric Bien |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417360090 PECOS PAC ID: 1557774783 Enrollment ID: I20210108000039 |
| Provider Name | Helen Linhong Zhang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1962865634 PECOS PAC ID: 0042503401 Enrollment ID: I20210610001783 |
| Provider Name | Tiffany Yuh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1790147072 PECOS PAC ID: 1456643766 Enrollment ID: I20210623001301 |
| Provider Name | Bogadi Louise Loabile |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1831540616 PECOS PAC ID: 6800135559 Enrollment ID: I20210802000613 |
| Provider Name | Emily Katherine Wunsch Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265051932 PECOS PAC ID: 3375934029 Enrollment ID: I20220106002337 |
| Provider Name | Aaron Richterman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912388281 PECOS PAC ID: 4880909266 Enrollment ID: I20220517002194 |
| Provider Name | Yotam Arens |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1497281430 PECOS PAC ID: 3577940006 Enrollment ID: I20220523000002 |
| Provider Name | Sahrish Ilyas |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1538523303 PECOS PAC ID: 2567754286 Enrollment ID: I20220621000835 |
| Provider Name | Arianne Morrison |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1083060727 PECOS PAC ID: 9830480185 Enrollment ID: I20220809001491 |
| Provider Name | Colleen M Werkmeister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063129732 PECOS PAC ID: 8729456546 Enrollment ID: I20221128002553 |
| Provider Name | Hadas Horenstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780301200 PECOS PAC ID: 9931577764 Enrollment ID: I20221128002903 |
| Provider Name | Katharine Brucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417664145 PECOS PAC ID: 2567830284 Enrollment ID: I20221130000364 |
| Provider Name | Alice Marcelle Ekobeni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487259164 PECOS PAC ID: 5294103891 Enrollment ID: I20221201000618 |
| Provider Name | Ross England |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1245624808 PECOS PAC ID: 0042526907 Enrollment ID: I20230619000564 |
| Provider Name | Sneha Thatipelli |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1861923427 PECOS PAC ID: 4385903335 Enrollment ID: I20230803001843 |
| Provider Name | Alyssa Kate Mezochow |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235627233 PECOS PAC ID: 7113275512 Enrollment ID: I20230907002295 |
| Provider Name | Kaitlyn Lorraine Broderick |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1962999540 PECOS PAC ID: 0840549051 Enrollment ID: I20230925000876 |
| Provider Name | Sara Clemens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538695911 PECOS PAC ID: 5193075075 Enrollment ID: I20231114002979 |
| Provider Name | Wei-teng Yang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871932368 PECOS PAC ID: 4284927724 Enrollment ID: I20231115000206 |
Laura Yatvin Nutrition Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 N. 5th Street, Philadelphia, PA 19140 Phone: 215-455-5370 Fax: 215-455-5374 | |
Health Hero Pa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 Dickinson St, Philadelphia, PA 19147 Phone: 484-667-3382 | |
Vo Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1735 Market St Fl 52, Philadelphia, PA 19103 Phone: 267-314-7252 | |
Rooted Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Tyson Ave, Philadelphia, PA 19149 Phone: 917-861-2531 | |
University Of Penn - Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, 3 Ravdin, Suite F, Pulmonary & Critical Care, Philadelphia, PA 19104 Phone: 215-662-3202 | |
Drexel Infectious Disease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 219 N Broad St, 5th Floor, Philadelphia, PA 19107 Phone: 215-762-6555 Fax: 215-762-3031 | |
Delaware Valley Medical Specialties Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 N 63rd St, Suite A, Philadelphia, PA 19151 Phone: 215-877-1100 Fax: 215-877-3710 |