LODESPOTO MEDICAL OF PA PLLC (NPI# 1164962148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164962148 |
Entity Type | Organization |
Organization Name | LODESPOTO MEDICAL OF PA PLLC |
Other Organization Name | LODESPOTO MEDICAL PLLC |
Practice Address |
1500 Market Street 12th Floor East Tower Philadelphia PA 19102-2152 |
Mailing Address |
Po Box 958 Port Jefferson Station NY 11776-0811 |
Practice Telephone | 4842827650 |
Practice Fax Number | 8889723585 |
Mailing Telephone | 4842827650 |
Mailing Fax Number | 8889723585 |
Enumeration Date | 2017-02-24 |
Last Update Date | 2017-10-25 |
Authorized Official Name | MARK J LODESPOTO (OWNER) |
Authorized Official Telephone | 4842827650 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085N0700X |
Radiology Specialization: Neuroradiology |
MD447488 | PA | Allopathic & Osteopathic Physicians |
Other Name | Type Code |
---|---|
Lodespoto Medical PLLC | Former Legal Business Name - Organization |
Street Address |
1500 MARKET STREET 12TH FLOOR EAST TOWER |
City | PHILADELPHIA |
State | PA |
Zip Code | 19102-2152 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659339232 | Corey Kades Ruth | Neuromusculoskeletal Medicine, Sports Medicine | 1500 Market Street, 24th Floor-west Tower, Philadelphia, PA 19102 | 2006-05-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821650847 | Alexandre Mason Sharma | Student in an Organized Health Care Education/Training Program | 200 N 16th St Apt 1318, Philadelphia, PA 19102 | 2019-06-29 |
1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
1245898170 | Parth Javia | Internal Medicine | 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-05 |
1588120968 | John Granger II | Social Worker | 1500 Market St. 12th Floor Suite 75, Philadelphia, PA 19102 | 2019-02-11 |
1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
1770076465 | Sarthi Dalal | Internal Medicine | 245 N 15th St, Fl 6, Ms 427, Philadelphia, PA 19102 | 2018-06-07 |
1255824033 | Joyce Nimo-boampong | Internal Medicine | Drexel University College of Medicine, 245 N 15th St, 6th Floor,ms 427, Philadelphia, PA 19102 | 2018-06-07 |
1134625692 | Emma Rose Gormley | Social Worker | 1601 Walnut St Ste 1516, Philadelphia, PA 19102 | 2018-04-03 |
1851808497 | Sunish Shah | Pharmacist | 230 N Broad St, Philadelphia, Pa 19102, Philadelphia, PA 19102 | 2018-01-04 |
Find all providers in zip 19102 |
Taxonomy Code | 2085N0700X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Neuroradiology |
A radiologist who diagnoses and treats diseases utilizing imaging procedures as they relate to the brain, spine and spinal cord, head, neck and organs of special sense in adults and children. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164664421 | Vitaly Izgur | Radiology | 2201 Strahle St, Apt A-12, Philadelphia, PA 19152-2530 | 2009-04-01 |
1164536827 | National Imaging P.C. | Radiology | 1903 S Broad St # 05, Philadelphia, PA 19148-2216 | 2006-08-19 |
1518903780 | Frederic Joshua Barnett | Radiology | 39th & Market Streets, Philadelphia, PA 19104 | 2006-06-22 |
1588620686 | Kedar Kulkarni | Radiology | 901 N Penn St, #302, Philadelphia, PA 19123-3132 | 2006-04-26 |
1194342980 | Sara Reis Teixeira | Radiology | 3401 Civic Center Blvd, Division of Pediatric Neuroradiology, Philadelphia, PA 19104-4319 | 2020-06-29 |
1073157376 | Anilawan Smitthimedhin | Radiology | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2019-10-30 |
1780165449 | Prabath Kumar Mondel | Radiology | 132 S 10th St Fl 10, Philadelphia, PA 19107-5244 | 2018-08-21 |
1114443082 | Seyed Ali Mosallaie | Radiology | 132 S 10th St, Philadelphia, PA 19107-5244 | 2017-08-22 |
1881114700 | Haykanush Zakaryan | Radiology | 132 S 10th St, Philadelphia, PA 19107-5244 | 2017-06-21 |
1134676596 | Caroline Lacroix | Radiology | 3401 Civic Center Blvd, Division of Neuroradiology, Philadelphia, PA 19104-4319 | 2016-09-02 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19102 |
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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.