Healthcare Provider Details

I. General information

NPI: 1235367459
Provider Name (Legal Business Name): TEMPLE PHYSICIANS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2009
Last Update Date: 06/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 N BROAD ST 3RD FL ROCK PAVILION
PHILADELPHIA PA
19140-5103
US

IV. Provider business mailing address

PO BOX 820933
PHILADELPHIA PA
19182-0933
US

V. Phone/Fax

Practice location:
  • Phone: 215-926-9022
  • Fax: 215-226-8286
Mailing address:
  • Phone: 215-926-9010
  • Fax: 215-226-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: ERIC MANKIN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: MD
Phone: 215-926-9050