Provider Demographics
NPI:1356452643
Name:PHILADELPHIA HEALTH & EDUCATION CORP
Entity Type:Organization
Organization Name:PHILADELPHIA HEALTH & EDUCATION CORP
Other - Org Name:DREXEL PRIMARY CARE ADULT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:SZKOLNICKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-255-3529
Mailing Address - Street 1:1500 MARKET ST
Mailing Address - Street 2:24TH FLOOR WEST TOWER
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2100
Mailing Address - Country:US
Mailing Address - Phone:215-255-3529
Mailing Address - Fax:215-832-2213
Practice Address - Street 1:3300 HENRY AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19129-1121
Practice Address - Country:US
Practice Address - Phone:215-842-6869
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA020248Medicare ID - Type Unspecified