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NPI Code Detail

MEDICARE: MERAKEY PHILADELPHIA

MEDICARE: MERAKEY PHILADELPHIA
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
1102L00000XPsychoanalyst

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 : 1578761029
Entity Type Code : Organization
Provider Name (Legal Business Name) : MERAKEY PHILADELPHIA
Provider Business Mailing Address
First Line : 620 GERMANTOWN PIKE
Second Line :
City : LAFAYETTE HILL
State : PA
Zip : 19444-1810
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Provider Business Practice Location Address
First Line : 27 E MOUNT AIRY AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19119-1713
Country : US
Telephone Number : 215-836-3131
Fax Number : 215-273-5975
Authorized Official
Title or Position : CORP SR. DIRECTOR OF BUSINESS OPS
Name : MR. NORMAN E TILSON JR.
Credential :
Telephone Number : 215-836-3131
Provider Enumeration Date : 07/06/2007
Last Update Date : 01/26/2024

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Directions to “MERAKEY PHILADELPHIA ” Practice Location

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