Healthcare Provider Details

I. General information

NPI: 1871834739
Provider Name (Legal Business Name): PREMIER MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2013
Last Update Date: 06/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 W RITNER ST
PHILADELPHIA PA
19145
US

IV. Provider business mailing address

1701 W RITNER ST
PHILADELPHIA PA
19145-4324
US

V. Phone/Fax

Practice location:
  • Phone: 215-336-2145
  • Fax: 215-336-5732
Mailing address:
  • Phone: 215-336-2145
  • Fax: 215-336-5732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL J ATTANASIO
Title or Position: DOCTOR
Credential: D.O
Phone: 215-336-2145