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NPI Code Detail

MEDICARE: TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

MEDICARE: TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
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
1208000000XPediatrics 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 : 1821086851
Entity Type Code : Organization
Provider Name (Legal Business Name) : TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Provider Business Mailing Address
First Line : 2450 W HUNTING PARK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19129-1302
Country : US
Telephone Number : 215-707-5437
Fax Number : 215-707-5180
Provider Business Practice Location Address
First Line : 3223 N BROAD ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19140-5007
Country : US
Telephone Number : 215-707-5437
Fax Number : 215-707-5180
Authorized Official
Title or Position : CREDENTIALING/MANAGER
Name : TONYA WOODARD
Credential :
Telephone Number : 215-707-3911
Provider Enumeration Date : 10/13/2005
Last Update Date : 06/15/2018

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Practice Location Address:
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1073091120 — DR. IVAN R MILORADOVIC DMD
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Practice Fax:
1912687187 — TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Practice Location Address:
3223 N BROAD ST
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Practice Fax: 215-707-5885
1366090094 — NICHOLAS BIZZARO DMD
Practice Location Address:
3223 N BROAD ST
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Practice Fax:
1073293528 — DR. MENG-HUA SHEN DMD
Practice Location Address:
3223 N BROAD ST
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1871581959 — DIONE J CASH MD
Practice Location Address:
3223 N BROAD ST
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Directions to “TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION ” Practice Location

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