TOWER DREXEL ACADEMIC MEDICAL GROUP LLC (NPI# 1205479904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205479904 |
| Entity Type | Organization |
| Organization Name | TOWER DREXEL ACADEMIC MEDICAL GROUP LLC |
| Other Organization Name | FAMILY MEDICINE TOWER HEALTH MEDICAL GROUP BROAD STREET |
| Practice Address |
219 N Broad St 8fl Philadelphia PA 19107-1507 |
| Mailing Address |
Po Box 13579 Reading PA 19612-3579 |
| Practice Telephone | 2157625145 |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | GARY CONNER (VP & CFO) |
| Authorized Official Telephone | 4846281324 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| FAMILY MEDICINE TOWER HEALTH MEDICAL GROUP BROAD STREET | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 219 N Broad St 8fl, Philadelphia, PA 191071507 | 2157625145 | |
| 219 N Broad St Fl 4, Philadelphia, PA 191071507 | 6107436049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457995938 | Tower Drexel Academic Medical Group LLC | Internal Medicine | 3401 Market St Ste 105b, Philadelphia, PA 19104-3315 | 2019-10-29 |
| 1811530512 | Tower Drexel Academic Medical Group LLC | Psychologist | 1427 Vine St Fl 1, Philadelphia, PA 19102-1031 | 2019-10-25 |
| 1407499148 | Tower Drexel Academic Medical Group LLC | Psychiatry & Neurology | 160 E Erie Ave Fl 2, Philadelphia, PA 19134-1011 | 2019-10-25 |
| 1215570916 | Tower Drexel Academic Medical Group LLC | Internal Medicine | 219 N Broad St Fl 6, Philadelphia, PA 19107-1519 | 2019-10-25 |
| 1003459702 | Tower Drexel Academic Medical Group LLC | Psychologist | 4700 Wissahickon Ave Ste C102, Philadelphia, PA 19144-4248 | 2019-10-25 |
| 1306479829 | Tower Drexel Academic Medical Group LLC | Family Medicine | 10 Shurs Ln Ste 206, Philadelphia, PA 19127-2123 | 2020-02-13 |
| 1346872116 | Tower Drexel Academic Medical Group LLC | Family Medicine | 219 N Broad St, 8th Fl, Philadelphia, PA 19107-1519 | 2020-02-10 |
| 1225660095 | Tower Drexel Academic Medical Group LLC | Family Medicine | 3401 Market St Ste 105a, Philadelphia, PA 19104-3315 | 2020-02-10 |
| 1144868084 | Tower Drexel Academic Medical Group LLC | Family Medicine | 10 Shurs Ln Ste 206, Philadelphia, PA 19127-2123 | 2019-12-11 |
| 1386281608 | Tower Drexel Academic Medical Group LLC | Psychiatry & Neurology | 1513 Race St, Philadelphia, PA 19102-1125 | 2019-12-05 |
| Street Address |
219 N BROAD ST 8FL |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19107-1507 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578170940 | Stephanie Quist | Pharmacist | 1 S Broad Street, Philadelphia, PA 19107 | 2020-09-29 |
| 1457968448 | Cloudline Physical Therapy LLC | Physical Therapist | 239-241 South 10th St, Philadelphia, PA 19107 | 2020-09-24 |
| 1053931303 | Wilson Wong | Pharmacist | Cvs Pharmacy #450, 3401 Walnut St, Philadelphia, PA 19107 | 2020-04-16 |
| 1326608779 | Pascal Lavergne | Neurological Surgery | 111 11th St, Thomas Jefferson University, Philadelphia, PA 19107 | 2019-06-18 |
| 1639632185 | Taylor D'amore | Orthopaedic Surgery | 925 Chest Street 5th Floor, Philadelphia, PA 19107 | 2019-04-11 |
| 1043779630 | Heather Lynn Yenser | Nurse Practitioner | 111 S. 11th St., Jefferson Vascular Center (6th Floor), Philadelphia, PA 19107 | 2019-03-14 |
| 1174093702 | Jennifer Lynn Kengeter | Psychologist | 900 Walnut Street, Suite 200, Philadelphia, PA 19107 | 2018-11-27 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922588623 | Hyung Bin Lee | Dentist | 315 N 12th St, Apt 803, Philadelphia, PA 19107 | 2018-08-21 |
| 1750860490 | Anastasiya Khlypnych | Physician Assistant | 111 S. 11th Street, Suite 2170, Gibbon Bldg Suite 6210, Philadelphia, PA 19107 | 2018-08-13 |
| Find all providers in zip 19107 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| 1225648140 | Action Health Centers Inc | Family Medicine | 1006 W Lehigh Ave Ste 200, Philadelphia, PA 19133-1640 | 2020-08-05 |
| 1285289876 | Visiting Doctors Inc | Family Medicine | 2338 S Broad St Ste 1, Philadelphia, PA 19145-4450 | 2019-08-09 |
| 1770137218 | Health Care At Northeast Philadelphia LLC | Family Medicine | 3353 Cottman Avenue, Philadelphia, PA 19149-1603 | 2019-08-01 |
| 1679131585 | Aria Health Physician Services | Family Medicine | 3998 Red Lion Rd Ste 204, Philadelphia, PA 19114-1440 | 2019-06-05 |
| 1689232597 | Aria Health Physician Services | Family Medicine | 5000 Frankford Ave Ste 1, Philadelphia, PA 19124-2620 | 2019-06-05 |
| 1174096432 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 2300 W Master St Ste 109b, Philadelphia, PA 19121-4739 | 2019-01-09 |
| 1679043152 | Prevention Point Philadelphia | Family Medicine | 2913-15 Kensington Ave, Philadelphia, PA 19134-3016 | 2018-11-28 |
| 1700362266 | Wes Corporation | Family Medicine | 5000 N 13th St, Philadelphia, PA 19141-3533 | 2018-07-17 |
| 1376046508 | Philly Medical and Rehab Associates | Family Medicine | 6401 Rising Sun Ave, Philadelphia, PA 19111-5228 | 2018-03-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19107 |
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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.