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General NPI Number Information
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NPI Number | 1861827305
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE RENAL CARE, PC
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Dates
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Enumeration Date | 09/03/2013
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Last Update Date | 09/03/2013
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Provider Practice Location Address
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Address Line | 2701 HOLME AVE STE 203
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City | PHILADELPHIA
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State | PA
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Zip | 19152-2029
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Country | US
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Telephone | 215-331-0515
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Fax | 215-331-8144
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Provider Business Mailing Address
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Address Line | PO BOX 45914
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City | PHILADELPHIA
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State | PA
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Zip | 19149-5914
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Country | US
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Telephone | 215-830-9991
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANNA DUBYANSKITE
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Credential | M.D.
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Telephone | 215-830-9991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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