NORTHERN LIBETIES WELLNESS CENTER (NPI# 1346668530) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346668530 |
| Entity Type | Organization |
| Organization Name | NORTHERN LIBETIES WELLNESS CENTER |
| Practice Address |
520 N Delaware Ave Suite 202 Philadelphia PA 19123-4226 |
| Practice Telephone | 2152393097 |
| Practice Fax Number | 2152393098 |
| Mailing Telephone | 2152393097 |
| Mailing Fax Number | 2152393098 |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2014-04-03 |
| Authorized Official Name | DR. WAYNE GIBBONS (OWNER) |
| Authorized Official Telephone | 21523930697 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
MD 038770L | PA | Ambulatory Health Care Facilities |
| Street Address |
520 N DELAWARE AVE SUITE 202 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19123-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184650475 | Ramesh Koneru | Psychiatry & Neurology | 520 N Delaware Ave, Suite # 4d, Philadelphia, PA 19123-4226 | 2006-06-25 |
| 1831568955 | Diagnostic Testing Services | Chiropractor | 520 N Delaware Ave, Suite 202, Philadelphia, PA 19123-4226 | 2015-09-18 |
| 1760890875 | Cecelia Rex | Specialist | 520 N Delaware Ave, Suite 202, Philadelphia, PA 19123-4226 | 2014-08-01 |
| 1528214426 | Desrene Debbie Ann Freemand | Psychiatry & Neurology | 520 N Delaware Ave, Philadelphia, PA 19123-4226 | 2008-08-11 |
| 1003970765 | Joseph E Fisher | Psychologist | 520 N Delaware Ave, 3d, Philadelphia, PA 19123-4226 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301842 | Regina Ann Griffin | Massage Therapist | 721 West Brown Street, Apt 1r, Philadelphia, PA 19123 | 2020-09-16 |
| 1811453558 | Terence Jones | Counselor | 1200 Callowhill St., Suite 101, Philadelphia, PA 19123 | 2019-02-19 |
| 1750874517 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 456 N 5th St, Philadelphia, PA 19123 | 2018-06-07 |
| 1649761677 | Dawn Webster | Acupuncturist | 466 N 10th St, Philadelphia, PA 19123 | 2018-05-25 |
| 1629566237 | Tri-county Home Health Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 443-45 W. Girard Ave, Ste 2b, Philadelphia, PA 19123 | 2018-04-30 |
| 1508389214 | Greater Delaware Valley Society of Transplant Surgeons | Organ Procurement Organization | 401 N. 3rd Street, Philadelphia, PA 19123 | 2017-07-25 |
| 1770987588 | Eugene Borys | Social Worker | 1217 Spring Garden Street, 1st Fl, Bebashi Transition To Hope, Philadelphia, PA 19123 | 2014-10-22 |
| 1134521255 | 9th & Girard Pharmacy Inc | Pharmacy | 901 W Girard Ave, #105, Philadelphia, PA 19123 | 2014-09-19 |
| 1508271925 | Waleska Santiago, PC | Internal Medicine | 1 Brown Street Unit 1414, Philadelphia, PA 19123 | 2014-06-24 |
| 1366865537 | Keli Hunter | Chiropractor | 683 N. Broad Street, Philadelphia, PA 19123 | 2014-01-24 |
| Find all providers in zip 19123 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811510936 | Ally Wellness LLC | Clinic/Center | 7 S 43rd St Apt 1, Philadelphia, PA 19104-3797 | 2020-05-22 |
| 1295378388 | Masters Rehabilitation Center | Clinic/Center | 9 N 52nd St, Philadelphia, PA 19139-2644 | 2019-10-22 |
| 1003391376 | Physiomove LLC | Clinic/Center | 10050 Roosevelt Blvd Unit 11, Philadelphia, PA 19116-3965 | 2018-10-02 |
| 1700307329 | Bones Fitness Partnerships | Clinic/Center | 1528 Walnut St Ste 300, Philadelphia, PA 19102-3626 | 2017-07-05 |
| 1659811354 | Ascend Orthopaedics | Clinic/Center | 1500 Walnut St Ste 7001a, Philadelphia, PA 19102-3523 | 2017-02-28 |
| 1689067472 | Mydoc Urgent Care | Clinic/Center | 1420 Locust St Unit R1a, Philadelphia, PA 19102-4223 | 2015-03-18 |
| 1205228160 | Jerry A Toomer | Clinic/Center | 1610 Cecil B Moore Ave, Philadelphia, PA 19121-3210 | 2015-03-02 |
| 1568629681 | South Philadelphia Ps | Clinic/Center | 1 Reed St, Philadelphia, PA 19147-5501 | 2008-05-16 |
| 1356543615 | Pt-one, LLC | Clinic/Center | 1835 Market St, 2nd Floor, Philadelphia, PA 19103-2968 | 2007-05-31 |
| 1568581098 | Occupational Health Centers of The Southwest, P.a., P.C. | Clinic/Center | 7000 Holstein Ave., Philadelphia, PA 19153 | 2007-03-28 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19123 |
Please comment or provide details below to improve the information on NORTHERN LIBETIES WELLNESS CENTER.
| 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.