WEDGE MEDICAL CENTER, PC (NPI# 1215176342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215176342 |
| Entity Type | Organization |
| Organization Name | WEDGE MEDICAL CENTER, PC |
| Practice Address |
4243 Frankford Avenue Philadelphia PA 19124 |
| Mailing Address |
6701 N Broad St Philadelphia PA 19126-2837 |
| Practice Telephone | 2157443600 |
| Practice Fax Number | 2157441400 |
| Mailing Telephone | 2152763922 |
| Mailing Fax Number | 2152768199 |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |
| Authorized Official Name | MRS. TAKISA S. GALLMAN (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 2152763922 |
| Authorized Official Credential | B.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
807343 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 100728192 | 05 |
| Street Address |
4243 FRANKFORD AVENUE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831749308 | William Mark Hanna Sr. | Pharmacist | 4600 Rooselvelt Blvd Bldg G, Philadelphia, PA 19124 | 2019-09-17 |
| 1881256451 | Medical Discovery Systems, LLC | Durable Medical Equipment & Medical Supplies | 5425 Oxford Ave., 5425 Oxford Ave. Suite (3 A), Philadelphia, PA 19124 | 2019-07-03 |
| 1548731391 | Sierra Pinkney | Registered Nurse | 1615 Granite St, Philadelphia, PA 19124 | 2018-12-05 |
| 1922507987 | Xavier Sergio Henriquez | Counselor | 4510 Frankford Avenue 2nd Floor, Philadelphia, PA 19124 | 2018-02-06 |
| 1558881581 | Isabel Cristina Castillo Hernandez | Pediatrics | 4500-10, Apt 201b, Philadelphia, PA 19124 | 2017-06-21 |
| 1952843732 | Patrick Grugan | Social Worker | Roosevelt Boulevard & Adams Avenue, Philadelphia, PA 19124 | 2016-11-10 |
| 1811340482 | Katarzyna Liwski | Psychiatry & Neurology | 4641 Roosevelt Boulevard, E212, Drexel University College of Medicine Friends Hospital, Philadelphia, PA 19124 | 2016-07-19 |
| 1851769327 | Aleka Kostouros | Social Worker | Roosevelt Blvd & Adams Ave, Northeast Community Center for Behavioral Health, Philadelphia, PA 19124 | 2015-09-14 |
| 1407230378 | Sara Bachani | Psychiatry & Neurology | 4641 Roosevelt Blvd, Friends Hospital, Room 231, Philadelphia, PA 19124 | 2015-07-10 |
| 1215327051 | Alyssa Renee Kirk | Counselor | 4500-10 Frankford Ave, 2nd Floor, Philadelphia, PA 19124 | 2015-02-02 |
| Find all providers in zip 19124 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386269231 | Rasheeda Jackson | Counselor | 117 Rosemar St, Philadelphia, PA 19120-1922 | 2020-06-16 |
| 1275170763 | Erika Anaya Kellogg | Counselor | 3535 Market St Dept Of, Philadelphia, PA 19104-3309 | 2019-12-04 |
| 1568008480 | Heather Mcgee | Counselor | 3343 Bowman St, Philadelphia, PA 19129-1538 | 2019-11-26 |
| 1104468222 | Johann Ochoa | Counselor | 3900 Woodland Ave Bldg 3, Philadelphia, PA 19104-4551 | 2019-10-09 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1447805114 | Sobriety Now LLC. | Counselor | 100 S Broad St Ste 2230, Philadelphia, PA 19110-1021 | 2019-08-08 |
| 1811453558 | Terence Jones | Counselor | 1200 Callowhill St., Suite 101, Philadelphia, PA 19123 | 2019-02-19 |
| 1215400106 | David Francis Ross Sr. | Counselor | 622 W Chew Ave Ste 2, Philadelphia, PA 19120-2211 | 2019-01-03 |
| 1124502604 | Saida Heywood | Counselor | 1306 Catharine St, Philadelphia, PA 19147-2628 | 2018-09-20 |
| 1437649415 | Ashley Przywitowski | Counselor | 9815 Roosevelt Blvd Ste B, Philadelphia, PA 19114-1035 | 2018-05-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19124 |
Please comment or provide details below to improve the information on WEDGE MEDICAL CENTER, PC.
| 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.