Individual
MR. IDAN AVIV WAKSMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3400 SPRUCE STREET, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(617) 633-6414
Mailing address
3400 SPRUCE STREET, GROUND SILVERSTEIN BLDG, PHILADELPHIA, PA 19104-4206
(215) 662-6698
(215) 662-3953
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
25MP00556700
NJ
363A00000X
Physician Assistant
Primary
MA061390
PA
Other
Enumeration date
01/13/2020
Last updated
04/17/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us