NPIMap

Organization Active NPI

Lifeline Health and Wellness Physician Specialty Group

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1225384563
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP
Practice address
1341 N Delaware Ave
Suite 307
Philadelphia, PA 19125-4300
Phone
(215) 922-9334
Fax
(215) 420-1777
NPI assigned
Jul 24, 2012
Last updated
Jul 24, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Authorized official

Name
Arthur Paul Miriana
Title
Ceo
Phone
(609) 703-6905

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
General Practice Physician 208D00000X

Addresses

Primary practice location

1341 N Delaware Ave
Suite 307
Philadelphia, PA 19125-4300

Mailing address

1341 N Delaware Ave
Suite 307
Philadelphia, PA 19125-4300
Phone (215) 922-9334

National Provider Directory

National Provider Directory

Locations

1341 N Delaware Ave
Ste 307
Philadelphia, PA 19125
Phone (215) 922-9334

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1225384563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 N DELAWARE AVE",
            "address_2": "SUITE 307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191254300",
            "telephone_number": "215-922-9334",
            "fax_number": "215-420-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1341 N DELAWARE AVE",
            "address_2": "SUITE 307",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191254300",
            "telephone_number": "215-922-9334",
            "fax_number": "215-420-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE HEALTH AND WELLNESS PHYSICIAN SPECIALTY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "MIRIANA",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "16097036905"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.