PROHEALTH LEADERS LLC (NPI# 1053827485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053827485 |
| Entity Type | Organization |
| Organization Name | PROHEALTH LEADERS LLC |
| Practice Address |
9963 Bustleton Ave Philadelphia PA 19115-1557 |
| Mailing Address |
9715 Jeanes St Philadelphia PA 19115-1901 |
| Practice Telephone | 2154642753 |
| Practice Fax Number | 2154644738 |
| Mailing Telephone | 2154642753 |
| Mailing Fax Number | 2154644738 |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2020-01-13 |
| Authorized Official Name | ANITHA GEORGE (MEMBER) |
| Authorized Official Telephone | 2154642753 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
9963 BUSTLETON AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19115-1557 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442696 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2044 Red Lion Road, Philadelphia, PA 19115 | 2020-09-21 |
| 1639717762 | Cassondra Ondeck | Physical Therapist | Paul's Run Retirement Community, 9896 Bustleton Ave, Philadelphia, PA 19115 | 2019-12-19 |
| 1740747641 | Comfort Ride Transit Inc | Non-emergency Medical Transport (VAN) | 248 Geiger Road, Suite 201 Unit D, Philadelphia, PA 19115 | 2019-02-27 |
| 1386101400 | Ashley Thomas | Physician Assistant | 9331 Old Bustleton Ave Ste 100a, Philadelphia, PA 19115 | 2019-02-25 |
| 1659857027 | Kiesha Anita Abney | Occupational Therapy Assistant | Chapel Manor (genesis Rehabilitation) 1104 Welsh Road, Philadelphia, PA 19115 | 2018-07-18 |
| 1457844870 | Philadelphia Discount Pharmacy LLC | Pharmacist | 842 Red Lion Road Unit 13, Philadephia, PA 19115 | 2018-06-11 |
| 1770001828 | Ciarra Bell | Occupational Therapist | 828 Red Lion Rd, Philadelphia, PA 19115 | 2017-09-08 |
| 1245604008 | Saria Ibrahim | Counselor | 9651 Clark Street, Philadelphia, PA 19115 | 2015-11-17 |
| 1124413166 | Global Dental Plus LLC | Dentist | 9630 Bustleton Av 2nd Fl, Philadelphia, PA 19115 | 2015-04-06 |
| 1932510161 | Miriam John | Occupational Therapist | 9997 Sandy Road, Philadelphia, PA 19115 | 2014-05-09 |
| Find all providers in zip 19115 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427674407 | Jun Song | Internal Medicine | 3401 N Broad St Ste 801, Philadelphia, PA 19140-5103 | 2020-06-24 |
| 1932725264 | Aaron Leo Yazdian | Internal Medicine | 1335 South St Apt A, Philadelphia, PA 19147-1841 | 2020-06-23 |
| 1144846387 | Rishabh Khatri | Internal Medicine | 322 N Broad St Apt 1523, Philadelphia, PA 19102-1122 | 2020-06-23 |
| 1215564521 | Insight Home Physicians, PC | Internal Medicine | 7806 Cresheim Rd, Philadelphia, PA 19118-4003 | 2020-03-25 |
| 1457995938 | Tower Drexel Academic Medical Group LLC | Internal Medicine | 3401 Market St Ste 105b, Philadelphia, PA 19104-3315 | 2019-10-29 |
| 1205479904 | Tower Drexel Academic Medical Group LLC | Internal Medicine | 219 N Broad St 8fl, Philadelphia, PA 19107-1507 | 2019-10-25 |
| 1700439056 | Alvaro Goncalves Mendes Neto | Internal Medicine | 5501 Old York Rd # 363, Philadelphia, PA 19141-3018 | 2019-07-16 |
| 1720648223 | Ali Haydar | Internal Medicine | 245 N. 15th St, 6th Floor, Ms 42, Philadelphia, PA 19102 | 2019-06-17 |
| 1114587672 | Stephen Michael Pokrywa | Internal Medicine | Drexel University Com, Internal Medicine Residency, 245 N. 15th St., 6th Floor, Ms 427, Philadelphia, PA 19102-1178 | 2019-06-17 |
| 1124688734 | Aakash Patel | Internal Medicine | Drexel University College of Medicine-internal Medicine, 245 N. 15th St. 6th Floor, Ms 427, Philadelphia, PA 19102 | 2019-06-17 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19115 |
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| 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.