MEMPHIS STREET ACADEMY CHARTER SCHOOL NPI 1588040117

NPI Information

MEMPHIS STREET ACADEMY CHARTER SCHOOL is a pediatrics nurse practitioner in Philadelphia, PA. MEMPHIS STREET ACADEMY CHARTER SCHOOL NPI is 1588040117. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2950 MEMPHIS ST
PHILADELPHIA, PA
ZIP 19134-314
Phone: (215) 291-4709
Fax: (215) 291-4754

The provider's authorized official is Julie Emig .
The authorized official title is Executive Director and has the following contact phone number (215) 687-6286.

The CLIA number assigned to this NPI record is 39D0980852 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/5/2015 and was last updated on 8/5/2015.

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:

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