Astral Physicians PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS007932L Issued in PA

Legal business name

ASTRAL PHYSICIANS PC

Practice address

1251 N Howard St
Philadelphia, PA 19122-4612

Phone

(610) 216-4937

Fax

(215) 447-5169

NPI assigned

Feb 10, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Noi Walkenstein, D.O.

Title

President

Phone

(610) 216-4937

Specialties & licenses 1

Addresses

Other identifiers 4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1093856056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1251 N HOWARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224612",
            "telephone_number": "610-216-4937",
            "fax_number": "215-447-5169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1251 N HOWARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191224612",
            "telephone_number": "610-216-4937",
            "fax_number": "215-447-5169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTRAL PHYSICIANS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "WALKENSTEIN",
        "authorized_official_first_name": "NOI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-216-4937",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OS007932L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5542028",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP MEMBER PRO",
            "identifier": "025393WCN",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "385035",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "10938310",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Philadelphia, PA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.