Healthcare Provider Details

I. General information

NPI: 1548145717
Provider Name (Legal Business Name): DENISE HUZZY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DENISE SWYGERT-HUZZY

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1311 S 15TH ST
PHILADELPHIA PA
19146-4801
US

IV. Provider business mailing address

1311 S 15TH ST
PHILADELPHIA PA
19146-4801
US

V. Phone/Fax

Practice location:
  • Phone: 215-796-5180
  • Fax:
Mailing address:
  • Phone: 215-796-5180
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW143254
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: