FORT HEALTH MEDICAL GROUP PA NPI 1104690379

NPI Information

  • NPI: 1104690379
  • Provider Name: FORT HEALTH MEDICAL GROUP PA
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Address: 100 S JUNIPER ST FL 3
    PHILADELPHIA, PA
    ZIP 19107
  • Phone: (201) 208-2616

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NPI Details

FORT HEALTH MEDICAL GROUP PA is a pediatrics in Philadelphia, PA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. FORT HEALTH MEDICAL GROUP PA NPI is 1104690379. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

100 S JUNIPER ST FL 3
PHILADELPHIA, PA
ZIP 19107-316
Phone: (201) 208-2616

The provider's authorized official is Saba Haq .
The authorized official title is President and has the following contact phone number (949) 463-0650.

The enumeration date for this NPI number is 11/8/2023 and was last updated on 5/15/2025.

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 License Number License State Primary
1101YP2500XCounselorProfessionalNo
21041C0700XSocial WorkerClinicalNo
3106H00000XMarriage & Family TherapistNo
42084P0804XPsychiatry & NeurologyChild & Adolescent PsychiatryNo
5363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
6208000000XPediatricsYes

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: 3/30/2025

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