Organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Active
Parent organization
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Other names
Temple University School of Podiatric Medicine Ambulatory Surgical Ctr
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION
Authorized official
DR. LARRY MARK NEWMAN D.P.M (MEDICAL DIRECTOR)
(215) 625-5310
Entity
Organization
Contact information
Practice address
8TH AT RACE STREET, SECOND FLOOR, PHILADELPHIA, PA 19107-0000
(215) 625-5381
(215) 629-4904
Mailing address
PO BOX 827282, PHILADELPHIA, PA 19182-7282
(215) 625-5341
(215) 629-0716
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
15661501
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100778013-0691
—
PA
01
—
116487100
US DEPARTMENT OF LABOR
PA
01
—
2063664
BLUE SHIELD
PA
01
—
37394
HEALTH PARTNERS
PA
01
—
735070
HEALTH AMERICA HEALTH ASSURANCE/ COVENTRY/ FIRST HEALTH
PA
01
—
HU833
INTER COUNTY HEALTH PLAN
PA
01
—
U833
KEYSTONE MERCY/ AMERI HEALTH
PA
Enumeration date
08/15/2005
Last updated
04/10/2013
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