PHILADELPHIA VA CLINIC NPI 1659315380

NPI Information

PHILADELPHIA VA CLINIC is a va clinic center in Philadelphia, PA. PHILADELPHIA VA CLINIC NPI is 1659315380. The provider is registered as an organization entity type.

The provider's business location address is:

214 NORTH 4TH ST.
2ND FLOOR
PHILADELPHIA, PA
ZIP 19106
Phone: (215) 923-1163
Fax: (215) 923-4032

The provider's authorized official is Barbara Mayerick .
The authorized official title is Director, Business Development and has the following contact phone number (202) 254-0339.

The CLIA number assigned to this NPI record is 39D1042129 - other with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/15/2006 and was last updated on 8/22/2020.

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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