Active NPI
Vlada Matusovsky
- Pharmacist
- Philadelphia, PA
National Provider Identifier
1467669937
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP042393L
- Practice address
- Room 900 US Customhouse
2ND and Chestnut Streets
Philadelphia, PA 19106 - Phone
- (215) 717-3738
- NPI assigned
- May 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP042393L | PA | Primary |
Addresses
Primary practice location
Room 900 US Customhouse
2ND and Chestnut Streets
Philadelphia, PA 19106
Mailing address
3970 Buck Rd
Huntingdon Valley, PA 19006-2202
Phone (215) 938-8938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP042393L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467669937",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3970 BUCK RD",
"city": "HUNTINGDON VALLEY",
"state": "PA",
"postal_code": "190062202",
"telephone_number": "215-938-8938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROOM 900 US CUSTOMHOUSE",
"address_2": "2ND AND CHESTNUT STREETS",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19106",
"telephone_number": "215-717-3738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATUSOVSKY",
"first_name": "VLADA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP042393L",
"primary": true
}
],
"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 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.