MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES NPI 1164684601

NPI Information

NPI: 1164684601
Provider Name: MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES

Other Name: BROAD AND GRANGE FAMILY PRACTICE

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
5751 N BROAD ST
PHILADELPHIA, PA
ZIP 19141
Phone: (215) 843-0672
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MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES is a primary care clinic center in Philadelphia, PA. MT AIRY/ GERMANTOWN MEDICAL AND REHAB ASSOCIATES NPI is 1164684601. The provider is registered as an organization entity type.
The provider Other Name Is Broad And Grange Family Practice.

The provider's business location address is:

5751 N BROAD ST
PHILADELPHIA, PA
ZIP 19141-307
Phone: (215) 843-0672
Fax: (215) 843-0674

The provider's authorized official is George Edward Fisher .
The authorized official title is Medical Doctor and has the following contact phone number (215) 843-0672.

The enumeration date for this NPI number is 6/26/2008 and was last updated on 6/26/2008.

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
1	261QP2300X	Clinic/Center	Primary Care	MD061558L	PENNSYLVANIA	Yes

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	HMO2590672	OTHER	PENNSYLVANIA	AETNA US HEALTHCARE
2	G61513	MEDICARE UPIN	PENNSYLVANIA
3	30010670	OTHER	PENNSYLVANIA	KEYSTONE MERCY
4	34699 MD061558L	OTHER	PENNSYLVANIA	HEALTHPARTNERS
5	2265537000	OTHER		KHPE, PERSONAL CHOICE
6	954658	OTHER	PENNSYLVANIA	BLUE CROSS/ BLUE SHIELD

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: 11/14/2023

NPI Synchronization or Removal

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