Wedge Medical Center, PC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

807343 Issued in PA

Legal business name

WEDGE MEDICAL CENTER, PC

Practice address

4243 Frankford Avenue
Philadelphia, PA 19124

Phone

(215) 744-3600

Fax

(215) 744-1400

NPI assigned

Feb 12, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Takisa S. Gallman, B.S.

Title

Administrative Director

Phone

(215) 276-3922

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Wedge Medical Center PC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• The Wedge Medical Center, P.C.

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1053538447
  NPD tax ID
• The Wedge Medical Center, P.C.

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1396455945
  NPD tax ID
• The Wedge Medical Center, P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Philadelphia, PA
  • NPI 1508806886
  NPD tax ID
• The Wedge Medical Center, P.C.

  • Professional Counselor
  • Philadelphia, PA
  • NPI 1730306291
  NPD tax ID

Locations

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• The Wedge Medical Center, P.C.

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1396455945
  NPPES parent name
• Wedge Medical Center

  • Community/Behavioral Health Agency
  • Philadelphia, PA
  • NPI 1336792316
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana Cozma, M.D

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1578860672
  NPD (past)

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234396800000",
    "number": "1215176342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6701 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191262837",
            "telephone_number": "215-276-3922",
            "fax_number": "215-276-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4243 FRANKFORD AVENUE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19124",
            "telephone_number": "215-744-3600",
            "fax_number": "215-744-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDGE MEDICAL CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A",
        "authorized_official_last_name": "GALLMAN",
        "authorized_official_first_name": "TAKISA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "215-276-3922",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "807343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100728192",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrew S Wechsler, MD
• Julie Rebecca Wechsler, MD
• Lawrence R Wechsler, MD
• Michelle Wecker
• Wedge Medical Center
• Wedo Pahrmacy Inc
• Wedobigthings Corporation
• Wee Kare Home Care Agency LLC
• Madison M Weeden
• Sharaya I Weekley, BSW

• Addiction (Substance Use Disorder) Counselor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Addiction (Substance Use Disorder) Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.