MEDICARE: NATURAL XPESSION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1043051212
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATURAL XPESSION

Provider Business Mailing Address
First Line	:	6117 RIDGE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-1627
Country	:	US
Telephone Number	:	800-817-2943
Fax Number	:	267-360-9444

Provider Business Practice Location Address
First Line	:	6117 RIDGE AVE
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19128-1627
Country	:	US
Telephone Number	:	800-817-2943
Fax Number	:	267-360-9444

Authorized Official
Title or Position	:	OWNER
Name	:	ALVIN KINGCADE
Credential	:	PA
Telephone Number	:	215-237-9216

Provider Enumeration Date	:	06/03/2024
Last Update Date	:	06/03/2024

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Directions to “NATURAL XPESSION ” Practice Location

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