Organization
ASTRAL PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOI WALKENSTEIN D.O. (PRESIDENT)
(610) 216-4937
Entity
Organization
Contact information
Practice address
1251 N HOWARD ST, PHILADELPHIA, PA 19122-4612
(610) 216-4937
(215) 447-5169
Mailing address
1251 N HOWARD ST, PHILADELPHIA, PA 19122-4612
(610) 216-4937
(215) 447-5169
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
OS007932L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025393WCN
MEDICARE GROUP MEMBER PRO
PA
01
—
10938310
CAQH
PA
01
—
385035
BLUE SHIELD
PA
01
—
5542028
AETNA
PA
Enumeration date
02/10/2007
Last updated
04/20/2008
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