Provider Demographics
NPI:1275588543
Name:DR. HOUSE CALL
Entity Type:Organization
Organization Name:DR. HOUSE CALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PERNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-334-2200
Mailing Address - Street 1:1615 W OREGON AVE
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19145-4500
Mailing Address - Country:US
Mailing Address - Phone:215-334-2200
Mailing Address - Fax:215-334-1125
Practice Address - Street 1:1615 W OREGON AVE
Practice Address - Street 2:
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145-4500
Practice Address - Country:US
Practice Address - Phone:215-334-2200
Practice Address - Fax:215-334-1125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-24
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0391741001OtherKEYSTONE
PA000720954OtherHIGHMARK BLUE SHIELD
PA000720954Medicare ID - Type Unspecified