MALVERN CONSTITUTION LLC (NPI# 1700438660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700438660 |
| Entity Type | Organization |
| Organization Name | MALVERN CONSTITUTION LLC |
| Practice Address |
1930 S Broad St Philadelphia PA 19145-2328 |
| Mailing Address |
1000 Germantown Pike Ste G5 Plymouth Meeting PA 19462-2487 |
| Practice Telephone | 6109413390 |
| Mailing Telephone | 6109413390 |
| Mailing Fax Number | 6109413391 |
| Enumeration Date | 2019-07-11 |
| Last Update Date | 2019-07-11 |
| Authorized Official Name | MR. CHRISTIAN OWEN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6109413390 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | Hospitals |
| Street Address |
1930 S BROAD ST |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19145-2328 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437107596 | Khoi Dang | Pediatrics | 1930 S Broad St, 2nd Floor, Philadelphia, PA 19145-2328 | 2006-05-04 |
| 1124628060 | Kristen Mulray | Psychologist | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2020-10-29 |
| 1629540802 | Vivek N Brahmbhatt | Pharmacist | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2018-12-27 |
| 1902313810 | Reeba Baboo | Speech-Language Pathologist | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2018-01-02 |
| 1679082465 | Krista Coons | Psychologist | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2017-09-25 |
| 1962927194 | Adrienne Blaire Gallo | Psychologist | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2017-08-09 |
| 1710428859 | Kathleen Jasion | Counselor | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2017-03-08 |
| 1053766089 | Acute Care Physicians of Philadelphia LLC | Internal Medicine | 1930 S Broad St, Philadelphia, PA 19145-2328 | 2016-04-27 |
| 1285009696 | Dorothy Latella-zakhireh | Clinical Neuropsychologist | 1930 S Broad St, Ima, Philadelphia, PA 19145 | 2015-12-10 |
| 1740668409 | Ima Professional Services of Pa, PC | Public Health or Welfare | 1930 S Broad St, Suite 11, Philadelphia, PA 19145-2328 | 2015-05-14 |
| Find all providers in the same location | ||||
| 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 | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811440399 | Temple University Hospital | Psychiatric Hospital | 100 East Lehigh Ave Suite 305b, Philadelphia, PA 19125 | 2016-08-01 |
| 1316374432 | Hahnemann University Hospital | Psychiatric Hospital | 4700 City Avenue, Apt 12307, Philadelphia, PA 19131 | 2013-10-03 |
| 1922386358 | North Philadelphia Health System | Psychiatric Hospital | 801 W. Girard Ave, Philadelphia, PA 19122-4212 | 2011-08-03 |
| 1730480179 | St Lawrence Psychiatric Center | Psychiatric Hospital | 32735 County Route 29 Ste A, Philadelphia, NY 13673-4210 | 2010-11-16 |
| 1437662384 | Center City Healthcare, LLC | Psychiatric Hospital | 230 N Broad St, Philadelphia, PA 19102-1121 | 2017-11-14 |
| 1689193385 | Merakey Recovery Services | Psychiatric Hospital | 801 W Girard Ave, Philadelphia, PA 19122-4212 | 2017-09-13 |
| 1629468137 | Belmont Behavioral Hospital, LLC | Psychiatric Hospital | 4200 Monument Rd, Philadelphia, PA 19131-1625 | 2015-02-04 |
| 1417360009 | Kimberly Downing | Psychiatric Hospital | 3401 N Broad St, Philadelphia, PA 19140-5103 | 2014-06-11 |
| 1912341629 | Haven Behavioral Services of Philadelphia, LLC | Psychiatric Hospital | 3300 Henry Ave, Unit 4, Philadelphia, PA 19129-1121 | 2013-04-24 |
| 1952681967 | Temple University Hospital | Psychiatric Hospital | 100 E Lehigh Ave, Philadelphia, PA 19125-1012 | 2011-08-22 |
| 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.