PENNSYLVANIA PET ASSOCIATES LLC NPI 1710966080

NPI Information

NPI: 1710966080
Provider Name: PENNSYLVANIA PET ASSOCIATES LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

Address:
800 SPRUCE ST
SECOND FLOOR, WIDENER BUILDING
PHILADELPHIA, PA
ZIP 19107
Phone: (215) 829-6554
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PENNSYLVANIA PET ASSOCIATES LLC is a radiology clinic center in Philadelphia, PA. PENNSYLVANIA PET ASSOCIATES LLC NPI is 1710966080. The provider is registered as an organization entity type.

The provider's business location address is:

800 SPRUCE ST
SECOND FLOOR, WIDENER BUILDING
PHILADELPHIA, PA
ZIP 19107-130
Phone: (215) 829-6554
Fax: (215) 829-6552

The provider's authorized official is Edward J Grace .
The authorized official title is Director Of Institutional Relations and has the following contact phone number (610) 993-1640.

The enumeration date for this NPI number is 1/13/2006 and was last updated on 6/18/2008.

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	261QR0200X	Clinic/Center	Radiology			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	066282	MEDICARE ID-TYPE UNSPECIFIED

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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