| Nim Longevity | |
|
1717 Langhorne Newtown Rd Ste 402 Langhorne PA 19047-1086 | |
| (215) 750-7000 | |
| (215) 750-9572 |
| Full Name | Nim Longevity |
|---|---|
| Speciality | Internal Medicine |
| Location | 1717 Langhorne Newtown Rd Ste 402, Langhorne, Pennsylvania |
| Authorized Official Name and Position | Valeri Koganski (OWNER) |
| Authorized Official Contact | 2157507000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nim Longevity 1717 Langhorne Newtown Rd Ste 402 Langhorne PA 19047-1086 Ph: (215) 750-7000 | Nim Longevity 1717 Langhorne Newtown Rd Ste 402 Langhorne PA 19047-1086 Ph: (215) 750-7000 |
| NPI Number | 1093864043 |
|---|---|
| Provider Enumeration Date | 01/09/2007 |
| Last Update Date | 12/30/2021 |
| Certification Date | 12/30/2021 |
| Medicare PECOS PAC ID | 4880632686 |
|---|---|
| Medicare Enrollment ID | O20050421001191 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093864043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Valeri Koganski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285696948 PECOS PAC ID: 9739134156 Enrollment ID: I20050318000521 |
| Provider Name | Marika W Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578868659 PECOS PAC ID: 0648456723 Enrollment ID: I20110526000100 |
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