1629016183 NPI number — LITTMAN & HAMID MEDICAL ASSOCIATES, P.C.

Table of content: (NPI 1629016183)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629016183 NPI number — LITTMAN & HAMID MEDICAL ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITTMAN & HAMID MEDICAL ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1629016183
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7300 CITY LINE AVE
Provider Second Line Business Mailing Address:
SUITE 203
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19151-2218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-878-7050
Provider Business Mailing Address Fax Number:
215-878-3951

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7300 CITY LINE AVE
Provider Second Line Business Practice Location Address:
SUITE 203
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19151-2218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-878-7050
Provider Business Practice Location Address Fax Number:
215-878-3951
Provider Enumeration Date:
06/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LITTMAN
Authorized Official First Name:
MARIO
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
215-878-7050

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD 034443 E , 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: 2Y4736 . This is a "ELDERHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001630918 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0010575090003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2310759001 . This is a "KEYSTONE/KEYCARE/IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 98580 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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