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NPI Code Detail

MEDICARE: CORINA GAMBER PA-C

MEDICARE: CORINA GAMBER 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
1363A00000XPhysician AssistantMA062420PA

General Provider Information

NPI Number : 1346820461
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORINA GAMBER PA-C
Provider Business Mailing Address
First Line : 2804 SOUTHAMPTON RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19154-1207
Country : US
Telephone Number : 215-677-0930
Fax Number :
Provider Business Practice Location Address
First Line : 2804 SOUTHAMPTON RD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19154-1207
Country : US
Telephone Number : 215-677-0930
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2021
Last Update Date : 04/20/2021

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Directions to “ CORINA GAMBER PA-C” Practice Location

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