Organization
CARDIOLOGY CONSULTANTS OF GREATER PHILADELPHIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA M JOUKOVA M.D., PH.D. (OWNER)
(267) 307-9236
Entity
Organization
Contact information
Practice address
10752 BUSTLETON AVE, SUITE G, PHILADELPHIA, PA 19116-3367
(267) 307-9236
Mailing address
1420 LOCUST ST, APT. 23P, PHILADELPHIA, PA 19102-4223
(267) 307-9236
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD435017
PA
207RC0000X
Cardiovascular Disease Physician
25MA08508800
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
MD435017
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102431691 0001
—
PA
Enumeration date
01/24/2013
Last updated
03/28/2013
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