Provider Demographics
NPI:1154455798
Name:ALHOMSI, MOTAZ (MD)
Entity Type:Individual
Prefix:
First Name:MOTAZ
Middle Name:
Last Name:ALHOMSI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 E MOUNT AIRY AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-1713
Mailing Address - Country:US
Mailing Address - Phone:215-248-6700
Mailing Address - Fax:215-754-0218
Practice Address - Street 1:27 E MOUNT AIRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-1713
Practice Address - Country:US
Practice Address - Phone:215-248-6700
Practice Address - Fax:215-754-0218
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060492L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA016392M0XMedicare PIN
PAG78941Medicare UPIN
PA016392FG8Medicare PIN
PA016392Medicare ID - Type Unspecified