# METROPOLITAN NEPHROLOGY ASSOCIATES, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Metro Vascular Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043758790
- **Authorized official:** MS. JENNIFER MAXIMENKO MHA, RT (FACILITY ADMINISTRATOR)
- **Authorized official phone:** (215) 568-6822

## Contact information

- **Practice address:** 235 N BROAD ST, SUITE 100, PHILADELPHIA, PA 19107
- **Practice address phone:** (215) 568-6822
- **Practice address fax:** (215) 568-6833
- **Mailing address:** 235 N BROAD ST, SUITE 100, PHILADELPHIA, PA 19107-1511
- **Mailing address phone:** (215) 568-6822
- **Mailing address fax:** (215) 568-6833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0011X | Interventional Cardiology Physician | 22371501 | PA | — |
| 207RN0300X | Nephrology Physician | 22371501 | PA | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | 22371501 | PA | — |
| 2086S0129X | Vascular Surgery Physician | 22371501 | PA | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/02/2017
- **Last updated:** 07/25/2018