DR. DANY BOULOS (NPI# 1780830703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780830703 |
| Entity Type | Individual |
| Full Name | DR. DANY BOULOS |
| Credential | M.D. |
| Practice Address |
11000 Roosevelt Blvd 360 Philadelphia PA 19116-3961 |
| Mailing Address |
Po Box 820933 Philadelphia PA 19182-0933 |
| Practice Telephone | 2156771475 |
| Practice Fax Number | 2156773082 |
| Mailing Telephone | 2159269010 |
| Mailing Fax Number | 2152268685 |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2015-04-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | MD453720 | PA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 01068800A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | ANTHEM | 000000718849 | 01 |
| IN | 201024290 | 05 |
| Street Address |
11000 ROOSEVELT BLVD 360 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19116-3961 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073529509 | Lawrence Albert | Emergency Medicine | 11000 Roosevelt Blvd, 360, Philadelphia, PA 19116-3961 | 2006-08-01 |
| 1407240856 | Yonie Edouard | Physician Assistant | 11000 Roosevelt Blvd, 360, Philadelphia, PA 19116-3961 | 2015-03-24 |
| 1013307701 | Andrew Zenner | Pharmacy Technician | 11000 Roosevelt Blvd, Philadelphia, PA 19116-3961 | 2015-02-02 |
| 1134557903 | Katty Lyamzin | Physical Therapist | 11000 Roosevelt Blvd, Philadelphia, PA 19116 | 2013-10-14 |
| 1124460563 | Sunny Marvania | Pharmacist | 11000 Roosevelt Blvd, Philadelphia, PA 19116-3961 | 2013-07-26 |
| 1811248925 | Temple Physicians Inc | Family Medicine | 11000 Roosevelt Blvd, 360, Philadelphia, PA 19116-3961 | 2012-09-28 |
| 1437389335 | Pooja Midha | Pharmacist | 11000 Roosevelt Blvd, Philadelphia, PA 19116-3961 | 2009-07-26 |
| 1891971818 | Capstone Physical Therapy & Fitness LLC | Clinic/Center | 11000 Roosevelt Blvd, World Gym Fitness Center, Philadelphia, PA 19116-3961 | 2008-01-22 |
| 1700925369 | Philadelphia Academy Charter School | Local Education Agency (LEA) | 11000 Roosevelt Blvd, Philadelphia, PA 19116-3961 | 2007-02-06 |
| 1861507642 | Richard J. Mcmenamin Inc. | Pharmacy | 11000 Roosevelt Blvd, Philadelphia, PA 19116-3961 | 2006-08-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334466 | Ambassador Home Care Services LLC | Homemaker | 118080 Bustleton Av, Suite 301, Philadelphia, PA 19116 | 2020-07-23 |
| 1669919445 | Lenore Pierce Bailey | Social Worker | 15100 Dahlia Drive, Philadelphia, PA 19116 | 2017-01-31 |
| 1477938991 | Jessica Gabriela Dashevsky | Counselor | 467 Parlin St, Philadelphia, PA 19116 | 2015-07-27 |
| 1174949697 | Absolute Therapy Care LLC | Physical Therapist | 10125 Verree Rd Ste 100, Philadelphia, PA 19116 | 2014-03-07 |
| 1790107936 | Philmont Homecare, LLC | Home Health | 14500 Bustleton Avenue, Suite 208, Philadelphia, PA 19116 | 2014-01-07 |
| 1417381609 | Able Ambulance Inc. | Ambulance | 1017 Haldeman Ave., Philadelphia, PA 19116 | 2013-08-25 |
| 1821356718 | Timur Kakhramanov | Nurse Practitioner | 301 W.byberry Rd, Unit F-6, Philadelphia, PA 19116 | 2012-04-27 |
| 1982975173 | Simon Perelshteyn | Internal Medicine | 10172 Verree Rd, Philadelphia, PA 19116 | 2012-01-19 |
| 1841574449 | Irene Feldman | Pharmacist | 10000 Busteloton Ave, Philadelphia, PA 19116 | 2011-10-03 |
| 1992095590 | Long Life Ambulance, LLC | Ambulance | 10065 Sandmeyer Lane, 103, Philadelphia, PA 19116 | 2011-04-15 |
| Find all providers in zip 19116 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 | 19116 |
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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.