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NPI Code Detail

MEDICARE: TOWER DREXEL ACADEMIC MEDICAL GROUP LLC

MEDICARE: TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
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
12084P0800XPsychiatry Physician

Other Identifiers

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

General Provider Information

NPI Number : 1386281608
Entity Type Code : Organization
Provider Name (Legal Business Name) : TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Provider Business Mailing Address
First Line : PO BOX 13579
Second Line :
City : READING
State : PA
Zip : 19612-3579
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1513 RACE ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19102-1125
Country : US
Telephone Number : 610-734-6049
Fax Number :
Authorized Official
Title or Position : VP OF REVENUE INTEGRITY
Name : CHARLES MICHAEL VALENTINO JR.
Credential :
Telephone Number : 484-628-9380
Provider Enumeration Date : 12/05/2019
Last Update Date : 06/02/2026

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