MEDICARE: CHILDRENS HEALTH CARE ASSOCIATES, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NP0225X	Pediatric Dermatology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073608006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHILDRENS HEALTH CARE ASSOCIATES, INC

Provider Business Mailing Address
First Line	:	3401 CIVIC CENTER BLVD
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4319
Country	:	US
Telephone Number	:	267-425-9408
Fax Number	:

Provider Business Practice Location Address
First Line	:	3500 CIVIC CENTER BLVD FL 6
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-4395
Country	:	US
Telephone Number	:	215-590-1000
Fax Number	:	267-425-9299

Authorized Official
Title or Position	:	ENROLLMENT MANAGER
Name	:	CHERISH FLOWERS
Credential	:
Telephone Number	:	267-425-9408

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/06/2025

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Directions to “CHILDRENS HEALTH CARE ASSOCIATES, INC ” Practice Location

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