Provider Type Icon

FADEMOS FAMILY PRACTICE NPI 1801138896


NPI Information

NPI: 1801138896
Provider Name: FADEMOS FAMILY PRACTICE
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 39D2049634

Address:
16 OLD ASHTON RD STE 1
PHILADELPHIA, PA
ZIP 19152
Phone: (215) 613-5069
Get Directions

FADEMOS FAMILY PRACTICE is a primary care clinic center in Philadelphia, PA. FADEMOS FAMILY PRACTICE NPI is 1801138896. The provider is registered as an organization entity type.

The provider's business location address is:

16 OLD ASHTON RD STE 1
PHILADELPHIA, PA
ZIP 19152-661
Phone: (215) 613-5069
Fax: (215) 613-6809

The provider's authorized official is Mariam Salahou .
The authorized official title is Ceo/clinical Director and has the following contact phone number (215) 613-5069.

The CLIA number assigned to this NPI record is 39D2049634 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/18/2013 and was last updated on 3/18/2013.


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
1261QP2300XClinic/CenterPrimary CareSP008704PENNSYLVANIAYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.