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NPI Code Detail

MEDICARE: MS. GINA MARIE POPPITI PA-C

MEDICARE: MS. GINA MARIE POPPITI PA-C
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
1207T00000XNeurological Surgery PhysicianMA059539PA
2363AS0400XSurgical Physician AssistantMA059539PA

General Provider Information

NPI Number : 1093084675
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. GINA MARIE POPPITI PA-C
Provider Business Mailing Address
First Line : 51 N. 39TH STREET
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4238
Country : US
Telephone Number : 215-294-9456
Fax Number : 215-222-8646
Provider Business Practice Location Address
First Line : 51 N. 39TH STREET
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4238
Country : US
Telephone Number : 215-294-9456
Fax Number : 215-222-8646
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2011
Last Update Date : 03/10/2026

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