Organization
AVELLINA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIOLETTA BERDICHEVSKAYA M.D. (OWNER)
(215) 938-1353
Entity
Organization
Contact information
Practice address
2375 WOODWARD ST, PHILADELPHIA, PA 19115-5120
(215) 676-9223
Mailing address
PO BOX 1628, HORSHAM, PA 19044-6628
(215) 830-9991
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001642076
BLUESHIELD
PA
05
—
0019378550006
—
PA
Enumeration date
03/14/2008
Last updated
03/25/2015
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