Provider Demographics
NPI:1184671653
Name:COBBS CREEK MEDICAL ASSOCIATES,P.C
Entity Type:Organization
Organization Name:COBBS CREEK MEDICAL ASSOCIATES,P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMYANTI
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNEJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-748-1143
Mailing Address - Street 1:1314 BOBARN DR
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-1136
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 S 60TH ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19143-2312
Practice Address - Country:US
Practice Address - Phone:215-748-1143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035169L261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA167521Medicare ID - Type Unspecified
PAC32623Medicare UPIN