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General NPI Number Information
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NPI Number | 1407612344
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Entity Type | Organization
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Legal Business Name | ADDICTION CONSULTANTS OF PENNSYLVANIA LLC
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 01/13/2026
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Provider Practice Location Address
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Address Line | 7600 CENTRAL AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19111-2442
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Country | US
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Telephone | 304-951-3599
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Fax |
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Provider Business Mailing Address
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Address Line | 717 S CHRISTOPHER COLUMBUS BLVD UNIT 1610
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City | PHILADELPHIA
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State | PA
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Zip | 19147-3514
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Country | US
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Telephone | 304-951-3599
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Fax |
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Authorized Official
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Title or Position | ATTENDING PHYSICIAN
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Name | SRIKRISHNA V MALAYALA
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Credential | MD
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Telephone | 304-951-3599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number |
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License Number State |
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