Healthcare Provider Details

I. General information

NPI: 1568536803
Provider Name (Legal Business Name): ANDRE BERNARD POSNER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 01/05/2023
Certification Date: 01/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 S 54TH ST
PHILADELPHIA PA
19143-1900
US

IV. Provider business mailing address

501 S 54TH ST
PHILADELPHIA PA
19143-1900
US

V. Phone/Fax

Practice location:
  • Phone: 215-748-9707
  • Fax: 215-748-9708
Mailing address:
  • Phone: 215-748-9707
  • Fax: 215-748-9708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberOS010079L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS010079L
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS010079L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: