Organization
CENTER CITY MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN BENJAMINI (OWNER)
(215) 331-0400
Entity
Organization
Contact information
Practice address
6722 BUSTLETON AVE, SUITE 102, PHILADELPHIA, PA 19149-2341
(215) 331-0400
Mailing address
6722 BUSTLETON AVE, SUITE 102, PHILADELPHIA, PA 19149-2341
(215) 331-0400
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0452591000
KEYSTONE HEALTH PLAN EAST
PA
01
—
453296
PERSONAL CHOISE
PA
Enumeration date
03/13/2008
Last updated
03/13/2008
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