Organization
MNAP MULTIPSECIALTY GROUP
Active
Other names
MNAP Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REGINA LEYMAN (OFFICE MANAGER)
(215) 673-9260
Entity
Organization
Contact information
Practice address
9908 ROOSEVELT BLVD, PHILADELPHIA, PA 19115-1705
(215) 673-9260
(215) 673-9254
Mailing address
9908 ROOSEVELT BLVD, PHILADELPHIA, PA 19115-1705
(215) 673-9260
(215) 673-9254
Taxonomy
Speciality
Code
Description
License number
State
173F00000X
Sleep Specialist (PhD)
MD048245L
PA
174400000X
Specialist
MD018061E
PA
174400000X
Specialist
MD024403E
PA
174400000X
Specialist
MD029547E
PA
174400000X
Specialist
Primary
MD422515
PA
174400000X
Specialist
MD432721
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019492480001
—
PA
01
—
1646499
HIGHMARK BLUE SHIELD
PA
01
—
2324240000
INDEPENDENCE BLUE CROSS
PA
Enumeration date
05/14/2010
Last updated
05/14/2010
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