NPI Code Details Logo

NPI 1376334128

NPI 1376334128 : FIRSTCHOICE MEDICAL PLLC : PHILADELPHIA, PA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1376334128
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    FIRSTCHOICE MEDICAL PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    05/13/2025
-----------------------------------------------------
    Last Update Date     |    05/13/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    9150 MARSHALL ST STE 18 
-----------------------------------------------------
    City                 |    PHILADELPHIA
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    19114-2217
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    617-712-6539
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    9150 MARSHALL ST STE 18 
-----------------------------------------------------
    City                 |    PHILADELPHIA
-----------------------------------------------------
    State                |    PA
-----------------------------------------------------
    Zip                  |    19114-2217
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     LIUBOU  USLAR 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    929-924-6024
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    207R00000X
-----------------------------------------------------
    Taxonomy Name        |    Internal Medicine Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.