Healthcare Provider Details

I. General information

NPI: 1457545071
Provider Name (Legal Business Name): PRISCILA RIBEIRO CUMMINGS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PRISCILA SCHALKIWJK RIBEIRO MD

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4417 NORTH 6TH STREET, ESPERANZA HEALTH CENTER
PHILADELPHIA PA
19140
US

IV. Provider business mailing address

4417 N. 6TH ST. ESPERANZA HEALTH CENTER
PHILADELPHIA PA
19140
US

V. Phone/Fax

Practice location:
  • Phone: 215-302-3150
  • Fax: 215-302-3151
Mailing address:
  • Phone: 215-302-3150
  • Fax: 215-807-8951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMT191372
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD443634
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: