1093708828 NPI number — DR. FRANK MACRI DPM

Table of content: DR. FRANK MACRI DPM (NPI 1093708828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093708828 NPI number — DR. FRANK MACRI DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACRI
Provider First Name:
FRANK
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DPM
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1093708828
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3910 HENRY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-877-7330
Provider Business Mailing Address Fax Number:
215-765-7776

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 BALA AVE STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALA CYNWYD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19004-3205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-877-7330
Provider Business Practice Location Address Fax Number:
215-877-7479
Provider Enumeration Date:
08/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC003259L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 001135679 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 524827 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0013268000 . This is a "IND BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1135679 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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