EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC (NPI# 1902440621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902440621 |
Entity Type | Organization |
Organization Name | EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC |
Practice Address |
4641 E Roosevelt Blvd Philadelphia PA 19124-2343 |
Mailing Address |
367 S Gulph Rd King of Prussia PA 19406-3121 |
Practice Telephone | 6103824943 |
Enumeration Date | 2019-11-06 |
Last Update Date | 2019-11-06 |
Authorized Official Name | TODD EVANS (VP) |
Authorized Official Telephone | 6103824943 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
Allopathic & Osteopathic Physicians | ||
N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PA | PENDING | 05 |
Street Address |
4641 E ROOSEVELT BLVD |
City | PHILADELPHIA |
State | PA |
Zip Code | 19124-2343 |
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 | 2084N0400X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Neurology |
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972060176 | Ncv Diagnostics LLC | Psychiatry & Neurology | 1 Brown St Ste C, Philadelphia, PA 19123-3361 | 2019-02-23 |
1982102133 | Sonia Anand-nichols Md PC | Psychiatry & Neurology | 5735 Ridge Ave Ste 101, Philadelphia, PA 19128-1746 | 2018-01-23 |
1205357886 | Kenneth Gross | Psychiatry & Neurology | 777 S Broad St Apt 412, Philadelphia, PA 19147-2509 | 2017-07-04 |
1417339409 | Leonel Jorge Favio Estofan | Psychiatry & Neurology | 245 N 15th St, 7th Floor, Philadelphia, PA 19102-1200 | 2015-06-25 |
1073900700 | Pavan Anil Vaswani | Psychiatry & Neurology | 330 S 9th St Fl 3, Philadelphia, PA 19107-6103 | 2015-04-21 |
1942613369 | Mia Chwan Ko | Psychiatry & Neurology | 5401 Old York Rd Ste 404, Philadelphia, PA 19141-3046 | 2014-06-03 |
1912340415 | Simy Kabaria Parikh | Psychiatry & Neurology | 900 Walnut St Ste 200, Philadelphia, PA 19107-5191 | 2013-04-15 |
1215295118 | Curtis Brandon Allumbaugh | Psychiatry & Neurology | 833 Chestnut St Ste 220, Philadelphia, PA 19107 | 2012-04-27 |
1013201870 | Enrique Aradillas Lopez | Psychiatry & Neurology | 1200 Constitution Ave Ste 110, Philadelphia, PA 19112-1323 | 2011-06-08 |
1598076358 | Hristelina S. Ilieva | Psychiatry & Neurology | 909 Walnut Street 2nd Floor, Philadelphia, PA 19107-3342 | 2010-06-27 |
Find all providers in PHILADELPHIA |
City | PHILADELPHIA |
Zip Code | 19124 |
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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.