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Organization
NORTHEAST PRIMARY CARE, PC
Active
Organization
NORTHEAST PRIMARY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DARIA L. DYKYJ (OFFICE MANAGER)
(215) 624-3000
Entity
Organization
Contact information
Practice address
8151 REVERE ST, 1ST FLOOR, PHILADELPHIA, PA 19152-3002
(215) 624-3000
(215) 624-6855
Mailing address
8151 REVERE STREET, 1ST FLOOR, PHILADELPHIA, PA 19152-3002
(215) 624-3000
(215) 624-6855
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD027187-E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891882973
INDIVIDUAL NPI NUMBER
PA
Enumeration date
02/09/2010
Last updated
02/09/2010
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