CRYSTAL A. GADEGBEKU (NPI# 1013099910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013099910 |
| Entity Type | Individual |
| Full Name | CRYSTAL A. GADEGBEKU |
| Credential | MD |
| Practice Address |
3401 N Broad St Philadelphia PA 19140-5103 |
| Mailing Address |
2450 W Hunting Park Ave Philadelphia PA 19129-1302 |
| Practice Telephone | 2157074600 |
| Mailing Telephone | 2157074600 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2018-04-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 4301081497 | MI | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
4301081497 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4520018 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1500 East Medical Center Dr, 3rd Floor Taubman Ctr Recp C, Ann Arbor, MI 481095348 | 7349365548 |
| Street Address |
3401 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942205133 | Shefali Agrawal | Specialist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2005-06-15 |
| 1962018523 | Caroline Grace Kelly | Audiologist | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-09-18 |
| 1457965964 | Barbara Ohiaeri | Pharmacist | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-09-02 |
| 1710505904 | Cara Greenspan | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-14 | |
| 1013535756 | Srinivasa Prasad Venkata Kanuparthi | Neurological Surgery | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1417575143 | Sakshi Gandhi | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-09 |
| 1801414594 | Azka Rahman | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-08 |
| 1417574658 | Anna-kaye Marie Brown | Anesthesiology | 3401 N Broad St, Philadelphia, PA 19140-5189 | 2020-07-04 |
| 1285251405 | Shalonda Cook | Internal Medicine | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| 1386261501 | Temidayo Aderibigbe | Orthopaedic Surgery | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2020-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578124038 | Ali Arif | Internal Medicine | 245 N 15th St Ste 6144, Philadelphia, PA 19102-1101 | 2019-06-25 |
| 1710344171 | Nina Stuccio | Internal Medicine | 410 S Front St Unit 215, Philadelphia, PA 19147-1708 | 2016-01-15 |
| 1497068613 | Anupama Nair | Internal Medicine | 1324 Locust St, Apt 205 The Arts Condominium, Philadelphia, PA 19107 | 2010-07-16 |
| 1972739621 | Mortimer M Civan | Internal Medicine | A303 Richards Building, 3700 Hamilton Walk, Dept. of Physiology, Univ. of Pennsylvania, Philadelphia, PA 19104-6085 | 2009-06-09 |
| 1790795391 | Arthur Robert Olshan | Internal Medicine | 205 N Broad St Ste 600, Philadelphia, PA 19107-1555 | 2006-08-08 |
| 1407817745 | Theodora K. Bernardini | Internal Medicine | 4453 Castor Ave, Suite B, Philadelphia, PA 19124-3846 | 2006-03-28 |
| 1902874670 | Eric J Bloom | Internal Medicine | 5501 Old York Road, Moss 4th Floor, Sley Building, Einstein Nephrology Associates, Philadelphia, PA 19141 | 2006-03-09 |
| 1821071473 | Edward R. Jones | Internal Medicine | 10 E Moreland Ave, Suite 100, Philadelphia, PA 19118-3541 | 2005-11-28 |
| 1366425092 | Peter Fumo | Internal Medicine | 10 E Moreland Ave Ste 100, Philadelphia, PA 19118-3562 | 2005-11-28 |
| 1790773547 | Ellie Kelepouris | Internal Medicine | 216 N. Broad St., 5th Floor, Philadelphia, PA 19102 | 2005-10-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
Please comment or provide details below to improve the information on CRYSTAL A. GADEGBEKU.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.