Ethel Lee Zachary Foundation

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

ETHEL LEE ZACHARY FOUNDATION

Practice address

5400 Lansdowne Ave Apt G2
Philadelphia, PA 19131-3916

Phone

(267) 386-6361

NPI assigned

Oct 14, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Amanhotep J Parker VI

Title

Ceo

Phone

(267) 386-6361

Specialties & licenses 1

Addresses

Other names 1

• Ethel Lee Zachary Foundation Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1602633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602633600000",
    "number": "1831797679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 LANSDOWNE AVE APT G2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191313916",
            "telephone_number": "267-386-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 LANSDOWNE AVE APT G2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191313916",
            "telephone_number": "267-386-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHEL LEE ZACHARY FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-14",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "AMANHOTEP",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-386-6361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "VI"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.facebook.com/ELZFDN",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5400 Lansdowne Ave Apt G2",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191313916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ethel Lee Zachary Foundation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher Jon Esworthy II, PA-C
• Eta Priority Transport Inc.
• Etana Care Inc
• Etapas Health Collective LLC
• Kambeze Banan Etemad, M.D.
• Mark Etherington, MD
• Dominique Etienne, PA-C
• Olivia Ann Etienne, MD
• Lisa Lucker Etkins, LCSW, OSW-C
• Abimbola Etou

• Student Health Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Student Health Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.