Healthcare Provider Details

I. General information

NPI: 1144687336
Provider Name (Legal Business Name): RHEUMATOLOGY CARE CENTER PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 E BALTIMORE PIKE
MEDIA PA
19063-5197
US

IV. Provider business mailing address

1022 E BALTIMORE PIKE
MEDIA PA
19063-5197
US

V. Phone/Fax

Practice location:
  • Phone: 484-428-3336
  • Fax: 484-301-0607
Mailing address:
  • Phone: 484-428-3336
  • Fax: 484-301-0607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number State

VIII. Authorized Official

Name: THAIS MOLDOVAN
Title or Position: OWNER
Credential: MD
Phone: 267-252-9250