South Philadelphia Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS008840L Issued in PA

Legal business name

SOUTH PHILADELPHIA FAMILY MEDICINE

Practice address

2243 S 9TH St
Philadelphia, PA 19148-3102

Phone

(215) 334-4049

Fax

(215) 462-9722

NPI assigned

Jul 10, 2006

Organization subpart

No

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

Authorized official

Name

Maria Mazzotti, DONPI 1689601288

Title

Owner

Phone

(215) 334-4049

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Maria Mazzotti, DO

  • Family Medicine Physician
  • Philadelphia, PA
  • NPI 1689601288
  NPD (past) Authorized official

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801820741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 LANKENAU AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191312827",
            "telephone_number": "215-334-4049",
            "fax_number": "215-462-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 S 9TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191483102",
            "telephone_number": "215-334-4049",
            "fax_number": "215-462-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PHILADELPHIA FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MAZZOTTI",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-334-4049",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS008840L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eirini Souroulidi, LSW
• Christine V Soutendijk, MD
• South Eastern Pennsylvania Medical Supplies
• South Philadelphia Dental Associates
• South Philadelphia Dental Group
• South Philadelphia Open MRI, LLC
• South Philadelphia Orthodontic Associates
• South Philadelphia Pain Management
• South Philadelphia Pediatrics
• South Philadelphia PS

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.