Healthcare Provider Details

I. General information

NPI: 1154355220
Provider Name (Legal Business Name): EINSTEIN PRACTICE PLAN, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E OLNEY AVE SUITE 400
PHILADELPHIA PA
19120-2421
US

IV. Provider business mailing address

5401 OLD YORK RD KLEIN BLDG, SUITE 410
PHILADELPHIA PA
19141-3030
US

V. Phone/Fax

Practice location:
  • Phone: 215-456-7000
  • Fax: 215-254-2599
Mailing address:
  • Phone: 215-456-7180
  • Fax: 215-456-2386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: FRANCINE BARGERON
Title or Position: DIRECTOR
Credential:
Phone: 215-456-7000