MEDICARE: COBBS CREEK MEDICAL ASSOCIATES,P.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
1	261Q00000X	Clinic/Center	MD035169L	PA

General Provider Information

NPI Number	:	1184671653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COBBS CREEK MEDICAL ASSOCIATES,P.C

Provider Business Mailing Address
First Line	:	1314 BOBARN DR
Second Line	:
City	:	NARBERTH
State	:	PA
Zip	:	19072-1136
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 S 60TH ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19143-2312
Country	:	US
Telephone Number	:	215-748-1143
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAMYANTI JUNEJA
Credential	:	M.D
Telephone Number	:	215-748-1143

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	08/22/2020

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