DEDICATED PENNSYLVANIA HOLDING, LLC (NPI# 1366950776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366950776 |
| Entity Type | Organization |
| Organization Name | DEDICATED PENNSYLVANIA HOLDING, LLC |
| Practice Address |
5675 N. Front Strreet Suite 141 Philadelphia PA 19120-1910 |
| Mailing Address |
1395 Nw 167th St Miami Gardens FL 33169-5710 |
| Practice Telephone | 3056286117 |
| Practice Fax Number | 3053635989 |
| Mailing Telephone | 3056286117 |
| Mailing Fax Number | 3053635989 |
| Enumeration Date | 2018-01-19 |
| Last Update Date | 2018-03-27 |
| Authorized Official Name | RAYMOND JIMENEZ (MANAGING DIRECTOR) |
| Authorized Official Telephone | 1786870403 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities | ||
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023655602 | Dedicated Pennsylvania Holding, LLC | Non-Pharmacy Dispensing Site | 330 W Oregon Ave # 170, Philadelphia, PA 19148-4723 | 2019-12-03 |
| 1942703137 | Dedicated Pennsylvania Holding, LLC | Specialist | 1575 N 52nd St Ste S-3, Philadelphia, PA 19131-4736 | 2018-03-14 |
| 1952804312 | Dedicated Pennsylvania Holding, LLC | Specialist | 2101 W Lehigh Ave Ste A, Philadelphia, PA 19132-2664 | 2018-03-13 |
| 1477053569 | Dedicated Pennsylvania Holding, LLC | Internal Medicine | 6431 Sackett St, Philadelphia, PA 19149-3118 | 2018-02-15 |
| 1841707965 | Dedicated Pennsylvania Holding, LLC | Family Medicine | 5675 N Front St Ste 141, Philadelphia, PA 19120-2719 | 2018-01-10 |
| Street Address |
5675 N. FRONT STRREET SUITE 141 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19120-1910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902364615 | Jane Clay Zakrzewski | Social Worker | Springfield Psychological, 1420 Walnut St. Suite 1500, Philadelphia, PA 19120 | 2019-03-12 |
| 1861964264 | Yi Ty Zhang | Nurse Practitioner | 101 E Olney Ave Ste C5, Philadelphia, PA 19120 | 2018-12-23 |
| 1447799770 | John Beecroft | Counselor | 4943 North 5th Street, Philadelphia, PA 19120 | 2017-02-20 |
| 1063869915 | Syed Naved Zahid | Dentist | 5675 Nth Front St., Philadelphia, PA 19120 | 2016-05-20 |
| 1447619838 | Danielle Green | Nurse Practitioner | 5846 North 4th St, Philadelphia, PA 19120 | 2016-02-15 |
| 1134544265 | Nt&t Corporation | Pharmacy | 439 West Chew Ave 1st F, Philadelphia, PA 19120 | 2014-02-26 |
| 1417234667 | Thomas Davis | Behavioral Analyst | 101 West Spencer Street, Philadelphia, PA 19120 | 2011-11-15 |
| 1619261682 | Advanced Family Dentistry, P.C. | Dentist | 6100-02 5th Street, Storefront, Philadelphia, PA 19120 | 2011-06-07 |
| 1346539061 | Capri N. Burt | Prosthetist | 5962 N. 3rd Street, Philadelphia, PA 19120 | 2011-04-04 |
| 1063719334 | James A. Brown | Prosthetist | 5962 N. 3rd St., Phila, PA 19120 | 2011-02-22 |
| Find all providers in zip 19120 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174156012 | Sade Yolanda Davis | Specialist | 2414 N Garnet St, Philadelphia, PA 19132-3725 | 2020-02-19 |
| 1356803993 | Larkerra Goodson | Specialist | 1336 Arrott St Apt E15, Philadelphia, PA 19124-3281 | 2019-04-03 |
| 1306302617 | Keisha Robinson | Specialist | 6852 Regent St, Philadelphia, PA 19142-1213 | 2019-02-12 |
| 1740758168 | William Whitaker | Specialist | 1115 E Sanger St, Philadelphia, PA 19124-1130 | 2018-11-02 |
| 1902395536 | Ran Barzilay | Specialist | 3440 Market St, Suite 200, Philadelphia, PA 19104 | 2018-05-09 |
| 1093229668 | Danielle M Marshall | Specialist | 514 Seville St Apt 7, Philadelphia, PA 19128-2737 | 2017-11-19 |
| 1336651017 | Radhia Afif | Specialist | 5943 Weymouth St, Philadelphia, PA 19120-1122 | 2017-11-02 |
| 1306383401 | Helping Hair LLC | Specialist | 930 N 50th St, Philadelphia, PA 19131-5102 | 2017-01-26 |
| 1447796172 | Kristen Halvorson | Specialist | 3411 Cresson St, Apartment 6, Philadelphia, PA 19129-1654 | 2017-01-19 |
| 1174079131 | Sadia Randolph | Specialist | 6718 Paschall Ave, Philadelphia, PA 19142-1809 | 2016-08-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19120 |
Please comment or provide details below to improve the information on DEDICATED PENNSYLVANIA HOLDING, LLC.
| 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.