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General NPI Number Information
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NPI Number | 1144339011
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Entity Type | Organization
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Legal Business Name | CARDIOVASCULAR MEDICAL ASSOCIATES, P C
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 04/26/2010
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Provider Practice Location Address
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Address Line | 818 CHESTNUT ST
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City | PHILADELPHIA
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State | PA
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Zip | 19107-5104
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Country | US
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Telephone | 215-629-1159
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Fax | 215-923-7621
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Provider Business Mailing Address
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Address Line | PO BOX 58263
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City | PHILADELPHIA
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State | PA
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Zip | 19102-8263
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Country | US
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Telephone | 215-629-1159
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Fax | 215-923-7621
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PHILIP NIMOITYN
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Credential | MD
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Telephone | 215-629-1159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD019676E
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License Number State | PA
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