MEDICALLY ASSISTED RECOVERY SERVICES INC (NPI# 1770960882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770960882 |
| Entity Type | Organization |
| Organization Name | MEDICALLY ASSISTED RECOVERY SERVICES INC |
| Practice Address |
10802 Bustleton Ave Philadelphia PA 19116-3302 |
| Practice Telephone | 2159696277 |
| Practice Fax Number | 2158567313 |
| Mailing Telephone | 2159696277 |
| Mailing Fax Number | 2158567313 |
| Enumeration Date | 2015-04-28 |
| Last Update Date | 2015-07-06 |
| Authorized Official Name | DR. JAN N WIDERMAN (PHYSICIAN) |
| Authorized Official Telephone | 2159696277 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
OS004029L | PA | Allopathic & Osteopathic Physicians |
| Street Address |
10802 BUSTLETON AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19116-3302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334466 | Ambassador Home Care Services LLC | Homemaker | 118080 Bustleton Av, Suite 301, Philadelphia, PA 19116 | 2020-07-23 |
| 1669919445 | Lenore Pierce Bailey | Social Worker | 15100 Dahlia Drive, Philadelphia, PA 19116 | 2017-01-31 |
| 1477938991 | Jessica Gabriela Dashevsky | Counselor | 467 Parlin St, Philadelphia, PA 19116 | 2015-07-27 |
| 1174949697 | Absolute Therapy Care LLC | Physical Therapist | 10125 Verree Rd Ste 100, Philadelphia, PA 19116 | 2014-03-07 |
| 1790107936 | Philmont Homecare, LLC | Home Health | 14500 Bustleton Avenue, Suite 208, Philadelphia, PA 19116 | 2014-01-07 |
| 1417381609 | Able Ambulance Inc. | Ambulance | 1017 Haldeman Ave., Philadelphia, PA 19116 | 2013-08-25 |
| 1821356718 | Timur Kakhramanov | Nurse Practitioner | 301 W.byberry Rd, Unit F-6, Philadelphia, PA 19116 | 2012-04-27 |
| 1982975173 | Simon Perelshteyn | Internal Medicine | 10172 Verree Rd, Philadelphia, PA 19116 | 2012-01-19 |
| 1841574449 | Irene Feldman | Pharmacist | 10000 Busteloton Ave, Philadelphia, PA 19116 | 2011-10-03 |
| 1992095590 | Long Life Ambulance, LLC | Ambulance | 10065 Sandmeyer Lane, 103, Philadelphia, PA 19116 | 2011-04-15 |
| Find all providers in zip 19116 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053957613 | Global Health and Recovery Services LLC | Internal Medicine | 3229 Kensington Ave, Philadelphia, PA 19134-1934 | 2019-11-19 |
| 1407027725 | Trusandra Elaine Taylor | Internal Medicine | 1745 N 4th St, Philadelphia, PA 19122-3008 | 2008-03-14 |
| 1619081726 | Bernard Amiel Harris | Internal Medicine | 2205 Bridge St, Philadelphia, PA 19137-1313 | 2006-08-18 |
| 1508490996 | Steadyhand Recovery | Internal Medicine | 1700 Market St Ste 1005, Philadelphia, PA 19103-3920 | 2020-02-25 |
| 1073095915 | Temple Faculty Practice Plan Inc | Internal Medicine | 3322 N Broad St, Philadelphia, PA 19140-5103 | 2018-09-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952946253 | Kaitlyn Renee Mackey | Internal Medicine | 33 Rollins Ln, Willow Street, PA 17584-8606 | 2019-11-10 |
| 1184177263 | Cleanslate Medical Group of Pennsylvania LLC | Internal Medicine | 100 N Wilkes Barre Blvd Ste 103, Wilkes Barre, PA 18702-5240 | 2016-07-26 |
| 1831559814 | Roxanne Rick | Internal Medicine | 2501 Mckeever St, Monongahela, PA 15063-4549 | 2016-03-03 |
| 1013301985 | Karen Sees | Internal Medicine | 1266 Lindholm Road, Kane, PA 16735 | 2015-03-27 |
| 1144473208 | Christopher Jackson Davis | Internal Medicine | 320 Loucks Rd, Suite 103, York, PA 17404-1752 | 2008-11-02 |
| 1598937245 | James Craig Berman | Internal Medicine | 261 Standish Rd, Merion Station, PA 19066-1133 | 2008-04-01 |
| 1255365151 | Kenneth W Thompson | Internal Medicine | 17 Camp Road, Richard J Caron Foundation, Wernersville, PA 19565 | 2006-07-10 |
| 1003846932 | Richard Arthur Hellander | Internal Medicine | 126 Easton Rd, Willow Grove, PA 19090 | 2006-07-04 |
| 1033173471 | Mikhail J Artamonov | Internal Medicine | 391 E Brown St, East Stroudsburg, PA 18301-9101 | 2006-04-13 |
| 1124025317 | Elizabeth G Lim | Internal Medicine | 250 Shady Ave, Pittsburgh, PA 15206-4316 | 2005-07-01 |
| Find all providers with the same taxonomy | ||||
| City | PHILADELPHIA |
| Zip Code | 19116 |
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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.