DR. GLENN HOWARD PISK (NPI# 1114971066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114971066 |
| Entity Type | Individual |
| Full Name | DR. GLENN HOWARD PISK |
| Credential | M.D. |
| Practice Address |
2129 W Oregon Ave First Floor Rear Philadelphia PA 19145-4131 |
| Practice Telephone | 2154626106 |
| Practice Fax Number | 2154625922 |
| Mailing Telephone | 2154626106 |
| Mailing Fax Number | 2154625922 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2013-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
MD0411084L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016075460001 | 05 |
| Street Address |
2129 W OREGON AVE FIRST FLOOR REAR |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19145-4131 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679540108 | Aaron Borgmann | Physical Therapist | 2129 W Oregon Ave, Philadelphia, PA 19145-4131 | 2006-03-03 |
| 1205385242 | Ryan Schmid | Physical Therapist | 2129 W Oregon Ave, 3rd Floor, Philadelphia, PA 19145-4131 | 2016-10-03 |
| 1861824625 | Caitlin Shaw | Physical Therapist | 2129 W Oregon Ave, 3rd Floor Suite, Philadelphia, PA 19145-4131 | 2013-08-05 |
| 1982943106 | Steven R Feldman | Physical Therapist | 2129 W Oregon Ave, Philadelphia, PA 19145-4131 | 2013-02-07 |
| 1679719645 | Michael Paul Keenan | Physical Therapist | 2129 W Oregon Ave, 3rd Floor, Philadelphia, PA 19145-4131 | 2008-12-22 |
| 1942451356 | Nicole Margaret Cannon | Physical Therapist | 2129 W Oregon Ave, Philadelphia, PA 19145-4131 | 2008-10-03 |
| 1801836671 | Pediatric and Adolescent Medicine Group | Pediatrics | 2129 W Oregon Ave, First Floor Rear, Philadelphia, PA 19145-4131 | 2006-06-08 |
| 1881632743 | Shannon Kathleen Campion | Physical Therapist | 2129 W Oregon Ave, Third Floor Suite, Philadelphia, PA 19145-4131 | 2006-06-03 |
| 1851360101 | Sharon M Elvey | Pediatrics | 2129 W Oregon Ave, First Floor Rear, Philadelphia, PA 19145-4131 | 2006-03-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518564350 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 2300a Rear W Oregon Ave, Philadelphia, PA 19145 | 2020-10-05 |
| 1376069559 | Kyle James Hughes | Physical Therapist | 2192 W Oregon Ave Fl 3, Philadelphia, PA 19145 | 2017-08-18 |
| 1821519752 | John A Takacs Dmd | Clinic/Center | 1707w Passyunk Ave, Philadelphia, PA 19145 | 2017-06-30 |
| 1033573209 | Kenneth Donahue | Dentist | 1517 Packer Avenue, Philadelphia, PA 19145 | 2016-04-13 |
| 1437516895 | Kimberly Wyand | Physical Therapist | 2129 Oregon St, Philadelphia, PA 19145 | 2016-01-15 |
| 1760856538 | Liji Vipin | Nurse Practitioner | 1615 Oregon Ave, Philadelphia, PA 19145 | 2015-11-17 |
| 1528333846 | Gina Marie Doyle | Registered Nurse | 1930 S. Broad Street, Philadelphia, PA 19145 | 2012-03-20 |
| 1639446214 | Thao T Tran | Pharmacist | 2014-24 South Broad St, Philadelphia, PA 19145 | 2011-11-25 |
| 1649573171 | Phyllis Yang | Internal Medicine | 1700 S Broad St, Unit 201, Philadelphia, PA 19145 | 2010-12-05 |
| 1326364613 | South Philadelphia Open Mri, LLC | Clinic/Center | 1834 West Oregon Avenue, Philadelphia, PA 19145 | 2010-04-13 |
| Find all providers in zip 19145 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516279 | Stc Pediatrics LLC | Pediatrics | 3601 A St Fl Family, Philadelphia, PA 19134-1043 | 2020-07-23 |
| 1386288702 | Advocare, LLC | Pediatrics | 2000 Hamilton St Ste 109, Philadelphia, PA 19130-3847 | 2019-10-29 |
| 1831427319 | Ellis H Sacks | Pediatrics | 2138 Lombard St, Apt 3b, Philadelphia, PA 19146-1261 | 2009-11-23 |
| 1144865791 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-11-07 |
| 1346884756 | Stc Pediatrics LLC | Pediatrics | 160 E Erie Ave, Philadelphia, PA 19134-1011 | 2019-10-30 |
| 1033647250 | Gladyne Confident | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2017-06-01 |
| 1104279694 | Rosheen Mary Grady | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2016-07-19 |
| 1235516006 | Shelby Hannah Davies | Pediatrics | 3401 Civic Center Blvd, Division of Adolescent Medicine, Philadelphia, PA 19104 | 2015-04-30 |
| 1326459371 | Philadelphia Women's Center, Inc. | Pediatrics | 777 Appletree St, 7th Floor, Philadelphia, PA 19106-1526 | 2014-05-13 |
| 1447677992 | Drisana Henry | Pediatrics | 3401 Civic Center Blvd, Philadelphia, PA 19104-4319 | 2014-03-22 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19145 |
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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.