Healthcare Provider Details

I. General information

NPI: 1609832286
Provider Name (Legal Business Name): ALBERT EINSTEIN MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 11/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 W TABOR RD
PHILA PA
19141
US

IV. Provider business mailing address

101 E OLNEY AVENUE STE 400
PHILA PA
19120
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-9020
  • Fax: 215-456-9084
Mailing address:
  • Phone: 215-456-7000
  • Fax: 215-254-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANCINE BARGERON
Title or Position: DIRECTOR
Credential:
Phone: 215-456-9020