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NPI Code Detail

MEDICARE: PATRICIA GENTLES MD

MEDICARE: PATRICIA GENTLES MD
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1154252799
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICIA GENTLES MD
Provider Business Mailing Address
First Line : 5501 OLD YORK RD STE 1
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-3098
Country : US
Telephone Number : 484-622-1000
Fax Number :
Provider Business Practice Location Address
First Line : 5501 OLD YORK RD STE 1
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19141-3098
Country : US
Telephone Number : 484-622-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2026
Last Update Date : 05/25/2026

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