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MEDICALLY ASSISTED RECOVERY SERVICES INC NPI 1770960882


NPI Information

NPI: 1770960882
Provider Name: MEDICALLY ASSISTED RECOVERY SERVICES INC
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
10802 BUSTLETON AVE
PHILADELPHIA, PA
ZIP 19116
Phone: (215) 969-6277
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MEDICALLY ASSISTED RECOVERY SERVICES INC is an addiction medicine internal medicine in Philadelphia, PA. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. MEDICALLY ASSISTED RECOVERY SERVICES INC NPI is 1770960882. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

10802 BUSTLETON AVE
PHILADELPHIA, PA
ZIP 19116-302
Phone: (215) 969-6277
Fax: (215) 856-7313

The provider's authorized official is Jan N Widerman .
The authorized official title is Physician and has the following contact phone number (215) 969-6277.

The enumeration date for this NPI number is 4/28/2015 and was last updated on 7/6/2015.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RA0401XInternal MedicineAddiction MedicineOS004029LPENNSYLVANIAYes

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

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