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General NPI Number Information
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NPI Number | 1700096351
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Entity Type | Individual
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Provider Name | JOSHUA EVAN KRAVETZ D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 09/22/2023
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Provider Practice Location Address
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Address Line | 5501 OLD YORK ROAD DEPARTMENT OF EMERGENCY MEDICINE
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City | PHILADELPHIA
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State | PA
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Zip | 19141
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Country | US
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Telephone | 215-456-6336
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 POWELL ST STE 900
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City | EMERYVILLE
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State | CA
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Zip | 94608-1844
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Country | US
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Telephone | 510-851-7423
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 20A13710
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License Number State | CA
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