Healthcare Provider Details

I. General information

NPI: 1174522114
Provider Name (Legal Business Name): ALBERT EINSTEIN MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2005
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5501 OLD YORK RD
PHILA PA
19141-3018
US

IV. Provider business mailing address

5501 OLD YORK RD
PHILA PA
19141-3018
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-6611
  • Fax: 215-457-4304
Mailing address:
  • Phone: 215-456-6611
  • Fax: 215-457-4304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number270601
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number270601
License Number StatePA

VIII. Authorized Official

Name: MR. SAMUEL RUSSO
Title or Position: CORP DIRECTOR OF FINANCE
Credential:
Phone: 215-456-6611