# TOWER DREXEL ACADEMIC MEDICAL GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY MEDICINE TOWER HEALTH MEDICAL GROUP BROAD STREET
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205479904
- **Authorized official:** CHARLES MICHAEL VALENTINO JR. (VP OF REVENUE INTEGRITY)
- **Authorized official phone:** (484) 628-9380

## Contact information

- **Practice address:** 219 N BROAD ST 8FL, PHILADELPHIA, PA 19107-1507
- **Practice address phone:** (215) 762-5145
- **Mailing address:** PO BOX 13579, READING, PA 19612-3579

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 10/25/2019
- **Last updated:** 06/02/2026