Organization
TEMPLE PHYSICIANS INC
Active
Parent organization
TEMPLE PHYSICIANS INC
Other names
TEMPLE PHYSICIANS SENIOR HEALTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEMPLE PHYSICIANS INC
Authorized official
ERIC MANKIN MD (CEO)
(215) 926-9050
Entity
Organization
Contact information
Practice address
9331 OLD BUSTLETON AVE, SUITE 100, PHILA, PA 19115-4204
(215) 671-0653
(215) 671-0970
Mailing address
9331 OLD BUSTLETON AVE, SUITE 100, PHILA, PA 19115-4204
(215) 671-0653
(215) 671-0970
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
597586
MEDICARE GROUP
PA
01
—
CD4829
RR MEDICARE
PA
Enumeration date
07/21/2009
Last updated
11/30/2010
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