=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740307248
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOEL D POMERANTZ, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 03/26/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7300 GERMANTOWN AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19119-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-242-3912
-----------------------------------------------------
Fax | 215-242-5567
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7300 GERMANTOWN AVE
-----------------------------------------------------
City | PHILADELPHIA
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19119-1725
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 215-242-3912
-----------------------------------------------------
Fax | 215-242-5567
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. JOEL DAVID POMERANTZ
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 215-242-3912
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0300X
-----------------------------------------------------
Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
-----------------------------------------------------
License Number | MD034625E
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------