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General NPI Number Information
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NPI Number | 1205246576
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Entity Type | Organization
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Legal Business Name | EINSTEIN PRACTICE PLAN, INC.
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 1200 W TABOR RD MOSS REHAB BUILDING, 4TH FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3019
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Country | US
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Telephone | 215-456-3815
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Fax | 215-456-6803
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Provider Business Mailing Address
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Address Line | PO BOX 788735
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City | PHILADELPHIA
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State | PA
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Zip | 19178-8735
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Country | US
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Telephone | 215-456-7000
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Fax | 215-254-3289
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Authorized Official
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Title or Position | DIRECTOR
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Name | MARY JACKSON
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Credential |
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Telephone | 215-456-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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