MEDICARE: GLADYS LORENA FION 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
1	207R00000X	Internal Medicine Physician	MD067977L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	P00025009	OTHER	PA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1370738	OTHER	PA	HIGHMARK BLUE SHIELD
2	30001625	OTHER	PA	KMHP
3	3Y2518	OTHER	PA	HEALTH NET
4	2062523000	OTHER	PA	INDEPENDENCE BLUE CROSS
6	3209015	OTHER	PA	AETNA HMO
7	483430	OTHER	PA	COVENTRY HEALTH AMERICA
8	7338285	OTHER	PA	AETNA PPO
9	9317	OTHER	PA	BRAVO HEALTH

General Provider Information

NPI Number	:	1821072059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLADYS LORENA FION MD

Provider Business Mailing Address
First Line	:	2450 W HUNTING PARK AVE
Second Line	:	2ND FL TPI
City	:	PHILA
State	:	PA
Zip	:	19129-1302
Country	:	US
Telephone Number	:	215-926-9019
Fax Number	:	215-226-8286

Provider Business Practice Location Address
First Line	:	100 E LEHIGH AVE
Second Line	:	CHC 1
City	:	PHILA
State	:	PA
Zip	:	19125-1000
Country	:	US
Telephone Number	:	215-707-1866
Fax Number	:	215-707-1876

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	08/14/2007

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Directions to “ GLADYS LORENA FION MD” Practice Location

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