Provider Demographics
NPI:1003853532
Name:PRIMARY CARE MEDICINE
Entity Type:Organization
Organization Name:PRIMARY CARE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGLIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-634-8000
Mailing Address - Street 1:2236 E ALLEGHENY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-3830
Mailing Address - Country:US
Mailing Address - Phone:215-634-8000
Mailing Address - Fax:215-634-1760
Practice Address - Street 1:2236 E ALLEGHENY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-3830
Practice Address - Country:US
Practice Address - Phone:215-634-8000
Practice Address - Fax:215-634-1760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1026412OtherKEYSTONE MERCY
PA0538478OtherAETNA HMO
PA0865743001OtherKEYSTONE EAST