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General NPI Number Information
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NPI Number | 1649161621
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Entity Type | Organization
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Legal Business Name | SPRINGHOUSE PSYCHIATRY PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/09/2025
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Last Update Date | 07/09/2025
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Provider Practice Location Address
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Address Line | 2418 E YORK ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3006
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Country | US
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Telephone | 267-777-9949
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Fax | 267-778-6105
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Provider Business Mailing Address
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Address Line | 2418 E YORK ST
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City | PHILADELPHIA
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State | PA
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Zip | 19125-3006
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Country | US
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Telephone | 267-777-9949
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Fax | 267-778-6105
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Authorized Official
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Title or Position | OWNER
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Name | SHAMEEM MOMIN
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Credential | MD
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Telephone | 267-663-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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