EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC NPI 1902440621

NPI Information

NPI: 1902440621
Provider Name: EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
4641 E ROOSEVELT BLVD
PHILADELPHIA, PA
ZIP 19124
Phone: (610) 382-4943
Get Directions

EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC is a neurology psychiatry neurology in Philadelphia, PA. The provider is 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. EASTERN PENNSYLVANIA PHYSICIAN ALLIANCE LLC NPI is 1902440621. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4641 E ROOSEVELT BLVD
PHILADELPHIA, PA
ZIP 19124-343
Phone: (610) 382-4943

The provider's authorized official is Todd Evans .
The authorized official title is Vp and has the following contact phone number (610) 382-4943.

The enumeration date for this NPI number is 11/6/2019 and was last updated on 11/6/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	2084N0400X	Psychiatry & Neurology	Neurology	Yes
2	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	No
3	363A00000X	Physician Assistant		No
4	363L00000X	Nurse Practitioner		No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	PENDING	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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