LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP (NPI# 1225384563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225384563 |
| Entity Type | Organization |
| Organization Name | LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP |
| Practice Address |
1341 N Delaware Ave Suite 307 Philadelphia PA 19125-4300 |
| Practice Telephone | 2159229334 |
| Practice Fax Number | 2154201777 |
| Mailing Telephone | 2159229334 |
| Mailing Fax Number | 2154201777 |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2012-07-24 |
| Authorized Official Name | ARTHUR PAUL MIRIANA (CEO) |
| Authorized Official Telephone | 16097036905 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
1341 N DELAWARE AVE SUITE 307 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19125-4300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699763144 | Greenstein Neurology Associates, P.C. | Specialist | 1341 N Delaware Ave, Suite 212, Philadelphia, PA 19125-4300 | 2005-10-10 |
| 1629473152 | Care Coordination Services, LLC | Preferred Provider Organization | 1341 N Delaware Ave, Suite 504, Philadelphia, PA 19125-4300 | 2014-10-27 |
| 1790991164 | Jeffrey I. Greenstein | Psychiatry & Neurology | 1341 N Delaware Ave, Suite 212, Philadelphia, PA 19125-4300 | 2007-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194241810 | Latiana Ridgell | Registered Nurse | 1080 N. Delaware Ave, Suite 300d, Phildelphia, PA 19125 | 2017-08-15 |
| 1659800175 | Michael William Pelekanos | Psychiatry & Neurology | 100 E. Lehigh Avenue Suite 305b, Philadelphia, PA 19125 | 2017-06-08 |
| 1063940187 | Travis J Dichoso | Psychiatry & Neurology | 100 E Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2017-06-02 |
| 1891232419 | Kristin Marie Iannuzzelli | Counselor | 1114 Earl Street, Philadelphia, PA 19125 | 2017-01-20 |
| 1811440399 | Temple University Hospital | Psychiatric Hospital | 100 East Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2016-08-01 |
| 1518343359 | Tamer Hassan Zayed Moustafa | Dentist | 100 E Lehigh Ave # Pm2, Philadelphia, PA 19125 | 2015-08-04 |
| 1235564337 | Ron Benjamin | Radiology | 2055 E Fletcher St, Philadelphia, PA 19125 | 2013-09-08 |
| 1457799165 | Ross Andrew Levine | Dentist | 100 E. Lehigh Ave, Pedatric Dental Associates, Philadelphia, PA 19125 | 2013-06-05 |
| 1518228543 | Kristen Kathleen Howland | Occupational Therapist | 404 East Flora St, Philadelphia, PA 19125 | 2012-06-06 |
| 1447539754 | Kiran Majeed | Psychiatry & Neurology | 100 E. Lehigh Aveune, Suite # 105, Philadelphia, PA 19125 | 2011-08-04 |
| Find all providers in zip 19125 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587227 | Cmp Medical LLC | Family Medicine | 3626 Sears St, Philadelphia, PA 19146-3217 | 2020-08-07 |
| 1225648140 | Action Health Centers Inc | Family Medicine | 1006 W Lehigh Ave Ste 200, Philadelphia, PA 19133-1640 | 2020-08-05 |
| 1285289876 | Visiting Doctors Inc | Family Medicine | 2338 S Broad St Ste 1, Philadelphia, PA 19145-4450 | 2019-08-09 |
| 1770137218 | Health Care At Northeast Philadelphia LLC | Family Medicine | 3353 Cottman Avenue, Philadelphia, PA 19149-1603 | 2019-08-01 |
| 1679131585 | Aria Health Physician Services | Family Medicine | 3998 Red Lion Rd Ste 204, Philadelphia, PA 19114-1440 | 2019-06-05 |
| 1689232597 | Aria Health Physician Services | Family Medicine | 5000 Frankford Ave Ste 1, Philadelphia, PA 19124-2620 | 2019-06-05 |
| 1174096432 | Temple University of The Commonwealth System of Higher Education | Family Medicine | 2300 W Master St Ste 109b, Philadelphia, PA 19121-4739 | 2019-01-09 |
| 1679043152 | Prevention Point Philadelphia | Family Medicine | 2913-15 Kensington Ave, Philadelphia, PA 19134-3016 | 2018-11-28 |
| 1700362266 | Wes Corporation | Family Medicine | 5000 N 13th St, Philadelphia, PA 19141-3533 | 2018-07-17 |
| 1376046508 | Philly Medical and Rehab Associates | Family Medicine | 6401 Rising Sun Ave, Philadelphia, PA 19111-5228 | 2018-03-14 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19125 |
Please comment or provide details below to improve the information on LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP.
| 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.