ARDI HERMAWAN (NPI# 1891267753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891267753 |
| Entity Type | Individual |
| Full Name | ARDI HERMAWAN |
| Credential | NP-C |
| Practice Address |
2101 W Lehigh Ave Ste A Philadelphia PA 19132-2664 |
| Mailing Address |
1395 Nw 167th St Miami Gardens FL 33169-5710 |
| Practice Telephone | 2678667211 |
| Mailing Telephone | 2678667211 |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2020-06-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
SP019639 | PA | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1700 Pine St, Norristown, PA 194013040 | 6102397100 | |
| 6150 Oak Tree Blvd Ste 200, Independence, OH 441312569 | 2165816556 |
| Street Address |
2101 W LEHIGH AVE STE A |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19132-2664 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356302715 | Patrick Timothy Waters | Family Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2006-03-28 |
| 1952804312 | Dedicated Pennsylvania Holding, LLC | Specialist | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2018-03-13 |
| 1982133195 | Mica Natasha Winchester | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2017-06-09 |
| 1932536232 | Ephraim Dunn | Family Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132 | 2013-10-01 |
| 1811256019 | Sharda Mukunda | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2012-05-08 |
| 1730491770 | Naiema A Benson | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2010-07-07 |
| 1518975325 | Kostiya Kana Peki | Internal Medicine | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811511017 | Irene Maria Clark | Social Worker | 3101 N. 29th St., Philadelphia, PA 19132 | 2020-06-03 |
| 1518407519 | Forget Me Knot Youth Services | Residential Treatment Facility, Emotionally Disturbed Children | 2321 N Broad Street, Philadelphia, PA 19132 | 2017-02-24 |
| 1609322437 | Shaakira Gillette | Social Worker | 2514 N. Broad St, Philadelphia, PA 19132 | 2016-08-31 |
| 1578017042 | Education Plus, Inc. | Nurse Practitioner | 3217 W. Clearfield Street, Philadelphia, PA 19132 | 2016-08-12 |
| 1972958544 | Rittenhouse Health LLC | Substance Abuse Rehabilitation Facility | 2321 N. Broad St, Philadelphia, PA 19132 | 2016-05-02 |
| 1336593458 | Jamal Vann | Counselor | 2233-43 West Allegheny Avenue, Philadelphia, PA 19132 | 2016-04-14 |
| 1487027132 | Jazzmin Devine | Specialist/Technologist | 200 Prospect St Hemlock 430a, East Stroudsburg University, PA 19132 | 2015-11-03 |
| 1609282508 | Lawrence Petitfrere | Pharmacist | 2801 W Dauphin St, Philadelphia, PA 19132 | 2014-07-11 |
| 1437565157 | Mental Health Partnerships | Community/Behavioral Health | 2709 N. Broad Street, Philadelphia, PA 19132 | 2014-07-02 |
| 1477977346 | Randy Morman | Counselor | 2514 N. Broad Street, 1st Floor, Philadelphia, PA 19132 | 2014-02-12 |
| Find all providers in zip 19132 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820622 | Diyong S Graham | Nurse Practitioner | 2812 Tremont St, Philadelphia, PA 19136-1025 | 2020-10-26 |
| 1750910808 | Alpha Integrated Clinic | Nurse Practitioner | 8019 Frankford Ave Rear, Philadelphia, PA 19136-2786 | 2020-04-01 |
| 1427681394 | Hwayoung Kim | Nurse Practitioner | 315 New St Apt 403, Philadelphia, PA 19106-1135 | 2020-02-19 |
| 1205306545 | Vadim Selyukov | Nurse Practitioner | 8815 Germantown Ave Ste 16, Philadelphia, PA 19118-2722 | 2018-11-29 |
| 1619420940 | Bridget Mccoy | Nurse Practitioner | 4929 Cedar Ave, Philadelphia, PA 19143-2013 | 2016-08-03 |
| 1003265489 | Stephanie Hand | Nurse Practitioner | 2409 Bainbridge St, Philadelphia, PA 19146-1014 | 2016-06-07 |
| 1679929095 | Michelle Marowitz | Nurse Practitioner | 3401 Civic Center Blvd Fl 11, Philadelphia, PA 19104 | 2016-05-05 |
| 1366834855 | Mary Morris | Nurse Practitioner | 1538 S 56th St, Philadelphia, PA 19143-4737 | 2015-02-20 |
| 1174920086 | Frances Garbarino | Nurse Practitioner | 501 S 53rd St, Philadelphia, PA 19143 | 2014-11-21 |
| 1033551130 | Mollie Evelyn Wilson | Nurse Practitioner | 5820 W Girard Ave, Philadelphia, PA 19131-4850 | 2013-07-18 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19132 |
Please comment or provide details below to improve the information on ARDI HERMAWAN.
| 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.