NPIMap

Organization Active NPI

Eastwick Primary Care

  • Primary Care Clinic/Center
  • Phila, PA
National Provider Identifier
1760580773
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
MD024544L Issued in PA
Legal business name
EASTWICK PRIMARY CARE
Practice address
2801 Island Rd
Suite 10 11
Phila, PA 19153-2326
Phone
(215) 492-8800
Fax
(215) 492-6421
NPI assigned
Sep 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
Mrs. Joyce M Fox, OFFICE MANAGER
Title
Office Manager
Phone
(215) 492-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X MD024544L PA Primary

Addresses

Primary practice location

2801 Island Rd
Suite 10 11
Phila, PA 19153-2326

Mailing address

2801 Island Ave
Suite 10 11
Phila, PA 19153-2326
Phone (215) 492-8800

Other identifiers 1

IdentifierTypeStateIssuer
144292OtherPABS

National Provider Directory

National Provider Directory

Locations

2801 Island Rd
Ste 10
Philadelphia, PA 19153
Phone (215) 492-8800

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1760580773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ISLAND AVE",
            "address_2": "SUITE 10 11",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191532326",
            "telephone_number": "215-492-8800",
            "fax_number": "215-492-6421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ISLAND RD",
            "address_2": "SUITE 10 11",
            "city": "PHILA",
            "state": "PA",
            "postal_code": "191532326",
            "telephone_number": "215-492-8800",
            "fax_number": "215-492-6421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTWICK PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "FOX",
        "authorized_official_first_name": "JOYCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "215-492-8800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OFFICE MANAGER"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "PA",
            "license": "MD024544L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "144292",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phila, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.