Individual
AVITAL MINTZ-MORGENTHAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5201 OLD YORK RD STE 311, PHILADELPHIA, PA 19141-2987
(215) 457-7700
(215) 457-3601
Mailing address
PO BOX 788735, PHILADELPHIA, PA 19178-8735
(215) 456-7000
(215) 254-3289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD490784
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104056722-0003
—
PA
Enumeration date
04/21/2022
Last updated
02/12/2026
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