THE WEDGE MEDICAL CENTER, P.C. (NPI# 1053538447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053538447 |
| Entity Type | Organization |
| Organization Name | THE WEDGE MEDICAL CENTER, P.C. |
| Practice Address |
3609 N Broad St Philadelphia PA 19140-4107 |
| Practice Telephone | 2152231100 |
| Practice Fax Number | 2152231200 |
| Mailing Telephone | 2152231100 |
| Mailing Fax Number | 2152231200 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. TAKISA S GALLMAN (ADMINISTRATIVE DIRECTOR) |
| Authorized Official Telephone | 2152763922 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
807376 | PA | Behavioral Health & Social Service Providers |
| X | 101YP2500X |
Counselor Specialization: Professional |
807376 | PA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1007281920005 | 05 | |
| PA | 1007281920009 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730306291 | The Wedge Medical Center, P.C. | Counselor | 2009 S Broad St, Philadelphia, PA 19148-2217 | 2007-04-19 |
| 1508806886 | The Wedge Medical Center, P.C. | Counselor | 6701 N Broad St, Philadelphia, PA 19126-2837 | 2006-06-07 |
| Street Address |
3609 N BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19140-4107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871710269 | Wmc | Counselor | 3609 N Broad St, Philadelphia, PA 19140-4107 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225640519 | Desirea Grant | Registered Nurse | 2000 W. Venango Street, Phila, PA 19140 | 2020-08-19 |
| 1306316104 | Carmen Doumit | Dentist | 3223 N Broad Street, Temple University Department of Orthodontics, Philadelphia, PA 19140 | 2018-12-05 |
| 1780150375 | Samantha Marina Felix | Counselor | 3803-3805 N 5th St, Philadelphia, PA 19140 | 2018-10-22 |
| 1518485135 | Holly Marie Barbee | Dietitian, Registered | 4417 N 6th St., Philadelphia, PA 19140 | 2017-09-04 |
| 1033630892 | Jessica Anne Tang | Otolaryngology | 3440 North Broad Street, Kresge West #300, Philadelphia, PA 19140 | 2017-07-03 |
| 1710416870 | Narsis Aminian | Internal Medicine | 3401 N Broad Street, Temple Hospital, Neurlogy Deartment, Philadelphia, PA 19140 | 2017-06-12 |
| 1629527338 | Alaa Khatib | Pharmacist | 4616-4650 N. Broad Street, Philadelphia, PA 19140 | 2016-09-23 |
| 1548716160 | Direct Home Health Care | In Home Supportive Care | 3550 N 9th St, Philadelphia, PA 19140 | 2016-09-01 |
| 1306399225 | Zaima Choudhry | Student in an Organized Health Care Education/Training Program | Department of Pulmonary and Sleep Medicine, 3401 North Broad Street, Zone C - 7th Floor, Philadelphia, PA 19140 | 2016-07-27 |
| 1891145504 | Saji Mathew | Pharmacist | 4530n 5th Street, Philadelphia, PA 19140 | 2016-06-14 |
| Find all providers in zip 19140 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386269231 | Rasheeda Jackson | Counselor | 117 Rosemar St, Philadelphia, PA 19120-1922 | 2020-06-16 |
| 1275170763 | Erika Anaya Kellogg | Counselor | 3535 Market St Dept Of, Philadelphia, PA 19104-3309 | 2019-12-04 |
| 1568008480 | Heather Mcgee | Counselor | 3343 Bowman St, Philadelphia, PA 19129-1538 | 2019-11-26 |
| 1104468222 | Johann Ochoa | Counselor | 3900 Woodland Ave Bldg 3, Philadelphia, PA 19104-4551 | 2019-10-09 |
| 1730735051 | Jill Verofsky | Counselor | 1180 Jfk Blvd, Suite 1110, Philadelphia, PA 19103 | 2019-08-13 |
| 1447805114 | Sobriety Now LLC. | Counselor | 100 S Broad St Ste 2230, Philadelphia, PA 19110-1021 | 2019-08-08 |
| 1811453558 | Terence Jones | Counselor | 1200 Callowhill St., Suite 101, Philadelphia, PA 19123 | 2019-02-19 |
| 1215400106 | David Francis Ross Sr. | Counselor | 622 W Chew Ave Ste 2, Philadelphia, PA 19120-2211 | 2019-01-03 |
| 1124502604 | Saida Heywood | Counselor | 1306 Catharine St, Philadelphia, PA 19147-2628 | 2018-09-20 |
| 1437649415 | Ashley Przywitowski | Counselor | 9815 Roosevelt Blvd Ste B, Philadelphia, PA 19114-1035 | 2018-05-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19140 |
Please comment or provide details below to improve the information on THE WEDGE MEDICAL CENTER, P.C..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.