MEDICARE: PORTIA CONIX D.O.

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	207Q00000X	Family Medicine Physician	OS007790L	PA

General Provider Information

NPI Number	:	1669406971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PORTIA CONIX D.O.

Provider Business Mailing Address
First Line	:	255 S 17TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-6231
Country	:	US
Telephone Number	:	215-546-7049
Fax Number	:	215-546-8646

Provider Business Practice Location Address
First Line	:	1300 S 18TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19146-4601
Country	:	US
Telephone Number	:	215-467-6320
Fax Number	:	215-755-5171

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/09/2007

Similar Medicare Providers

1306843073 — D&H PHARMACY SERVICES INC
Practice Location Address:

1300 S 18TH ST , REAR/PHARMACY
PHILADELPHIA, PA
19146-4601

Practice Phone: 215-468-1202
Practice Fax: 215-551-4068

1225036874 — MR. ROCCO JOSEPH DIMATTIA III RPH
Practice Location Address:

1300 S 18TH ST
PHILADELPHIA, PA
19146-4601

Practice Phone: 215-468-1202
Practice Fax: 215-551-4068

1326696535 — PHYLICIA F FLEMING PHD, NCSP
Practice Location Address:

4601 MARKET ST
PHILADELPHIA, PA
19139-4636

Practice Phone: 215-590-7555
Practice Fax:

1952065344 — IZABELA MILANIAK PHD
Practice Location Address:

4601 MARKET ST
PHILADELPHIA, PA
19139-4636

Practice Phone: 215-590-7555
Practice Fax:

1083476964 — MICHAEL BERNARD ROESCH BCBA,LBS
Practice Location Address:

4601 MARKET ST
PHILADELPHIA, PA
19139-4636

Practice Phone: 215-878-3400
Practice Fax: 267-531-0005

1720723042 — KATE BARTOLOTTA
Practice Location Address:

4601 MARKET ST
PHILADELPHIA, PA
19139-4636

Practice Phone: 800-879-2467
Practice Fax:

Directions to “ PORTIA CONIX D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.