Organization
TOWER DREXEL ACADEMIC MEDICAL GROUP LLC
Active
Other names
PSYCHIATRY TOWER HEALTH MEDICAL GROUP WISSAHICKON AVENUE
Organization subpart
No
Provider details
NPI number
Authorized official
GARY CONNER (VP & CFO)
(484) 628-1324
Entity
Organization
Contact information
Practice address
4700 WISSAHICKON AVE STE C102, PHILADELPHIA, PA 19144-4248
(610) 743-6049
Mailing address
PO BOX 13579, READING, PA 19612-3579
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
10/25/2019
Last updated
10/21/2020
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