Albert Einstein Medical Center
Organization Active NPI Psychologist · Phila, PA
NPI 1609832286 · NPPES record last updated Nov 1, 2007
Key facts
- NPI
- 1609832286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Psychologist 103T00000X
- Legal business name
- ALBERT EINSTEIN MEDICAL CENTER
- Practice address
- 1200 W Tabor Rd
Phila, PA 19141 - Phone
- (215) 456-9020
- Fax
- (215) 456-9084
- NPI assigned
- Apr 24, 2006
- Organization subpart
- No
Authorized official
- Name
- Francine Bargeron
- Title
- Director
- Phone
- (215) 456-9020
Other NPIs with the same Medicare PAC ID 7
Corporate family (same tax ID) 11
Practitioners 5
-
Mary Pelham, PSY.D
-
Sitara Shanmugam, PSYD
-
Sheryl Berardinelli, PSYD
-
Daniel J Leichter, PSYD
-
Eileen Fitzpatrick, PH.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040706000177 | PA | Part B Supplier - Clinic/Group Practice | 3971412297 |
Receives reassigned benefits from 5 practitioners Practice locations: Elkins Park, PA; Philadelphia, PA |
National Provider Directory
- Tax ID family
- Albert Einstein Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist |
103T00000X | Yes | ||
| Psychiatry Physician |
2084P0800X |
Addresses
Primary practice location
1200 W Tabor Rd
Phila, PA 19141
Mailing address
101 E Olney Avenue
Ste 400
Phila, PA 19120
Phone (215) 456-7000
Other providers in Phila, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.