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Organization
TEMPLE FACULTY PRACTICE PLAN INC
Active
Organization
TEMPLE FACULTY PRACTICE PLAN INC
Active
Other names
Temple Faculty Addiction Medicine, Temple Faculty Addiction Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BRIDGET FERRARIE (SR. MANAGER PAYER CREDENTIALING)
(215) 707-2433
Entity
Organization
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-2000
Mailing address
3500 N BROAD ST, PHILADELPHIA, PA 19140-4106
Taxonomy
Speciality
Code
Description
License number
State
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
—
NULL
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
—
—
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
NULL
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
11/06/2023
Last updated
11/06/2023
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