NORTHERN LIBERTIES WELLNESS GROUP (NPI# 1457737967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457737967 |
| Entity Type | Organization |
| Organization Name | NORTHERN LIBERTIES WELLNESS GROUP |
| Practice Address |
520 N Columbus Blvd Suite 202 Philadelphia PA 19123-4226 |
| Mailing Address |
Po Box 9900 Hamilton NJ 08650-1900 |
| Practice Telephone | 2152393097 |
| Practice Fax Number | 2152393098 |
| Mailing Telephone | 2152393097 |
| Mailing Fax Number | 2152393098 |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2015-08-06 |
| Authorized Official Name | MS. LOLAMARIE DAVIS (ADMINISTRATOR) |
| Authorized Official Telephone | 2152393096 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
DC002363 | PA | Chiropractic Providers |
| Y | 208D00000X | General Practice | OS011923 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
520 N COLUMBUS BLVD SUITE 202 |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19123-4226 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619957859 | Dominick Gregory Carfello | Chiropractor | 520 N Columbus Blvd, Suite 204, Philadelphia, PA 19123-4226 | 2006-01-21 |
| 1427413517 | Rx Plus LLC | Pharmacy | 520 N Columbus Blvd, Suite 202, Philadelphia, PA 19123-4226 | 2015-12-16 |
| 1174988265 | Pain Care Management, LLC | Health Maintenance Organization | 520 N Columbus Blvd, Suite 202, Philadelphia, PA 19123-4226 | 2015-12-16 |
| 1225261084 | St. John's Community Services | Day Training, Developmentally Disabled Services | 520 N Columbus Blvd, Philadelphia, PA 19123-4226 | 2009-08-27 |
| 1013077551 | Pmhcc Ctt Inc | Case Management | 520 N Columbus Blvd, 4d, Philadelphia, PA 19123-4226 | 2006-12-12 |
| 1831115559 | Mohamado Musthaq | Psychiatry & Neurology | 520 N Columbus Blvd, Philadelphia, PA 19123-4226 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301842 | Regina Ann Griffin | Massage Therapist | 721 West Brown Street, Apt 1r, Philadelphia, PA 19123 | 2020-09-16 |
| 1811453558 | Terence Jones | Counselor | 1200 Callowhill St., Suite 101, Philadelphia, PA 19123 | 2019-02-19 |
| 1750874517 | Pennsylvania Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 456 N 5th St, Philadelphia, PA 19123 | 2018-06-07 |
| 1649761677 | Dawn Webster | Acupuncturist | 466 N 10th St, Philadelphia, PA 19123 | 2018-05-25 |
| 1629566237 | Tri-county Home Health Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 443-45 W. Girard Ave, Ste 2b, Philadelphia, PA 19123 | 2018-04-30 |
| 1508389214 | Greater Delaware Valley Society of Transplant Surgeons | Organ Procurement Organization | 401 N. 3rd Street, Philadelphia, PA 19123 | 2017-07-25 |
| 1770987588 | Eugene Borys | Social Worker | 1217 Spring Garden Street, 1st Fl, Bebashi Transition To Hope, Philadelphia, PA 19123 | 2014-10-22 |
| 1134521255 | 9th & Girard Pharmacy Inc | Pharmacy | 901 W Girard Ave, #105, Philadelphia, PA 19123 | 2014-09-19 |
| 1508271925 | Waleska Santiago, PC | Internal Medicine | 1 Brown Street Unit 1414, Philadelphia, PA 19123 | 2014-06-24 |
| 1366865537 | Keli Hunter | Chiropractor | 683 N. Broad Street, Philadelphia, PA 19123 | 2014-01-24 |
| Find all providers in zip 19123 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
| 1124642996 | Wound Pros Medical Group | General Practice | 1500 Market Street 12th Floor, East Tower, Philadelphia, PA 19102-2152 | 2020-06-08 |
| 1831755735 | Good Hope Health Center Corp | General Practice | 7712 Buist Ave, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1366008260 | Ltc Treatment Center Inc | General Practice | 7712 Buist Ave Apt B, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1972072288 | Paula Alejandra Pino Pommer | General Practice | 3551 North Broad St., Philadelphia, PA 19140-4160 | 2018-11-15 |
| 1689183121 | Gem Wound Specialists, LLC | General Practice | 250 N Columbus Blvd Apt 707, Philadelphia, PA 19106-1458 | 2017-09-27 |
| 1023556875 | Bralow Medical Group | General Practice | 834 South St., Philadelphia, PA 19147 | 2017-02-01 |
| 1790135358 | Jeffrey Anthony Gazzara Jr. | General Practice | 621, 1515 Market Street, Suite 1200, Philadelphia, PA 19102-1921 | 2016-06-14 |
| 1053788240 | J. Todd Willis, Md Clinic | General Practice | 1003 Holland Avenue, Suite 104, Philadelphia, MS 39350-2180 | 2015-08-24 |
| 1225411655 | Brian Michael Lauer | General Practice | 609 E Passyunk Ave Apt 2, Philadelphia, PA 19147-1530 | 2015-07-02 |
| 1003294588 | Health Hero Pa LLC | General Practice | 217 Dickinson St, Philadelphia, PA 19147-6003 | 2015-05-15 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19123 |
Please comment or provide details below to improve the information on NORTHERN LIBERTIES WELLNESS 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.